The main task of therapeutic hemapheresis remains doing the right thing and doing the right thing right. If objective results have been slow to take hold it is in large part because several physicians have resisted continuous improvement since therapeutic apheresis was considered so efficient to boomerang preventing elimination of unnecessary procedures and treatments. The right thing to do is treating patients who may respond in a specific phase of their disease, frequently along with the right drugs. Doing right the right thing is to take advantage of the new technologies and, medical culture which have led apheresis to the recent complexity and efficacy. In the following pages we are trying to update the state-of-the-art and new trends which characterize therapeutic apheresis at the beginning of 2000.