Lymph node myeloid metaplasia associated with chronic neutrophilic leukemia.

All patients received the first plasma exchange employing fresh frozen plasma, and CPP was used in the following procedures. PE was performed daily until normalization of the platelet count and serum LDH levels. Two patients (B.S. and P.M.L.) died 8 and 5 days, respectively, after beginning plasma exchange, and the addition of highdose iv immunoglobulins in one case did not produce any effect. Clinical remission was reached in four patients. In one case, neurological disorders at onset such as amnesia and paresthesia improved after three PE procedures. Normalization of platelet count was obtained after 7, 11, 13 and 17 plasma exchange procedures, respectively. Our experience confirms the data reported by Perotti et al. regarding hematological recovery, while the neurological disorders that appeared during the treatment in two patients did not seem to be influenced by the addition of CPP. These observations seem to limit the efficacy of CPP as compared to fresh frozen plasma in the treatment of TPP.