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By way of background: in 1978 there was a possibility that plasma exchange would be of benefit in the treatment of rheumatoid arthritis and breast cancer. I was then running a regional apheresis service out of the Canadian Red Cross local centre in Ottawa and was very concerned that this activity would generate an enormous demand for plasma or albumin which we would not be able to meet on a regional or national basis.


An article then appeared in the Medical Post describing activities in apheresis at five different centres across the country. Representatives from some of these centres arranged to meet at ASH to compare notes and to discuss future activities as to how we could gather information to help in planning.


The national office of the Canadian Red Cross was approached but were unable to help us with this. I then sent a letter to the Minister of Health, Monique Begin, describing our concerns and our wish to get together to plan future activities. The response was for the federal government to arrange a meeting of the few physicians involved in apheresis centres across the country and this was held at Tunny’s Pasture in late 1979.


Based on concern for the security of the blood supply in the country, Health Canada then convened a national meeting in which the Minister requested the Deans of Medicine from each school to send a representative who, even if not then involved in apheresis, would be able to carry information to and from their location. At that meeting it was agreed by all to establish a small database to record current activities in apheresis and hopefully, provide some insight as to future requirements. Originally, this was done entirely on paper with an annual report sent from each active site to the Ottawa central office of what became the Canadian Apheresis Study Group.


Since that time, the system has been in place in most centres in the country and has evolved to an online database. This has proven extremely useful in terms of identifying the need for replacement fluids but equally so in generating information and allowing us to set up clinical trials to assess efficacy of the procedures. This has resulted in the publication of more than 40 joint papers, and has helped not only to establish criteria for apheresis and provide information for new centers and activities but the data has even been used by the CPSO to identify standards of practice in the country.


Gail Rock, PhD MD FRCP

Chair, Canadian Apheresis Group


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