Korean J Pediatr Hematol Oncol.  2002 Oct;9(2):250-254.

Therapeutic Leukapheresis for Acute Lymphoblastic Leukemia with Severe Hyperleukocytosis in a Six-Week-Old Infant (4.7 kg)

• Byun JY
• Shin KM
• Won SC
• Lyu CJ
• Lim HS
• Kim HO

Abstract

We report a 4.7 kg infant who received a therapeutic leukapheresis as an immediate treatment for acute lymphoblastic leukemia with severe hyperleukocytosis. By decreasing the number of circulating white blood cells, therapeutic leukapheresis helps prevent the risks of hyperviscosity and cerebrovascular and pulmonary leukostasis. In addition, it potentially reduces metabolic and renal complications associated with rapid cell lysis when applied before chemotherapy. This six-week-old female presented with vomiting for 15 days. Initial WBC count was 1,532,800/muL. After placement of 4 french two-lumen central venous catheter in both femoral vein, the CS 3000 plus was primed with 250 mL of paternal whole blood mixed with 150 mL of normal saline. After therapeutic leukapheresis, the CBC showed WBC count of 560,000/muL. Our successful experience in performing this procedure suggests that therapeutic leukapheresis be a feasible treatment even for very young infants with hyperleukocytosis.

Keyword

Therapeutic leukapheresis; Acute lymphoblastic leukemia; Hyperleukocytosis; Infant

MeSH Terms

Central Venous Catheters
Drug Therapy
Female
Femoral Vein
Humans
Infant*
Leukapheresis*
Leukocytes
Leukostasis
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
Vomiting