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Maxime Dely: Therapeutic Apheresis – How Do You Know When You Can’t Wait Any Longer?

Maxime Dely/LinkedIn

Jan 3, 2026, 08:13

Maxime Dely: Therapeutic Apheresis – How Do You Know When You Can’t Wait Any Longer?

Maxime Dely, Sales and Application Specialist in Therapeutic Apheresis and Cell Therapy, shared a post on LinkedIn:

“Therapeutic Apheresis: How do you know when you can’t wait any longer?
3 clinical criteria to decide on Therapeutic Apheresis

Therapeutic apheresis is neither an automatic reflex nor a last-resort treatment by default. The right indication relies on a structured clinical reasoning, which can be summarized into three key criteria.

1. A clearly identifiable circulating pathogenic target

Apheresis makes sense when the disease mechanism involves a blood-borne factor that can be mechanically removed:

– autoantibodies (TTP, myasthenia gravis, Goodpasture syndrome)
– immune complexes (severe lupus)
– abnormal cells (leukostasis in acute leukemias)
– lipoproteins (homozygous familial hypercholesterolemia)

Without a clearly identified circulating target, the expected benefit becomes questionable.

2. Acute or rapidly progressive clinical severity

Myasthenic crisis with respiratory failure, thrombotic thrombocytopenic purpura, progressive Guillain–Barré syndrome, antibody-mediated graft rejection…

In these situations, apheresis is a life-saving or organ-saving emergency intervention.

3. A mismatch between clinical urgency and the onset of action of standard therapies

Immunosuppressive drugs, IVIg, or chemotherapy may be effective — but sometimes too slow.

Therapeutic apheresis allows an immediate reduction of the pathogenic burden, stabilizing the patient and creating a therapeutic window.

Deciding on apheresis is not about ticking boxes on a list of indications. It is about integrating pathophysiology, clinical severity, and timing, through close multidisciplinary collaboration.

When properly indicated, apheresis is not a technical luxury — it is a strategic clinical tool.”

Maxime Dely: Therapeutic Apheresis - How Do You Know When You Can’t Wait Any Longer?