Korean J Blood Transfus.  2014 Aug;25(2):132-140. 10.0000/kjbt.2014.25.2.132.

Clinical Effects and Safety of Therapeutic Leukapheresis in Hyperleukocytosis

• Lee SN
• Kong JH
• Eom HS
• Lee H
• Park HJ
• Sohn JY
• Kong SY

• KMID: 2029269
• DOI: http://doi.org/10.0000/kjbt.2014.25.2.132

Abstract

BACKGROUND
Therapeutic leukapheresis is the cytoreduction procedure performed before chemotherapy in patients with hyperleukocytosis for prevention of complication. However, there have been clinical concerns about bleeding tendency due to anticoagulant used during the procedure. The aim of our study was to compare the clinical characteristics and hematological parameters before and after therapeutic leukapheresis in order to evaluate its effect on bleeding tendency and to provide a guideline for treatment strategy.
METHODS
The clinical data for 39 procedures of therapeutic leukapheresis performed on 17 patients with hyperleukocytosis from May 2005 to October 2013 at the National Cancer Center were reviewed retrospectively.
RESULTS
The patients consisted of 11 males and six females. The mean age was 41 years old (range, 8~74). The mean number of therapeutic leukapheresis per patient was two (range, 1~4). Clinical symptoms improved in 14 patients (82%) after therapeutic leukapheresis and three patients (18%) were not yet to improve. The mean WBC count was significantly reduced by 32.6% (+/-17.4) after therapeutic leukapheresis, from 250,146/microL (+/-117,000) to 174,702/microL (+/-104,700) (P<0.001). The mean volume of single removal was 298 ml with 4.25x10(11)/L (+/-1.54) WBCs. After therapeutic leukapheresis, the mean platelet count showed a decline from 85x10(9)/L (+/-43) to 71x10(9)/L (+/-26). However, the prothrombin time (PT) and activated partial thromboplastin time (aPTT) did not show a significant increase (PT, P=0.637; aPTT, P=0.054).
CONCLUSION
Therapeutic leukapheresis is demonstrated as an effective and safe treatment that can improve symptoms and reduce leukocytes in hyperleukocytosis.

Keyword

Therapeutic leukapheresis; Leukostasis; Hyperleukocytosis

MeSH Terms

Drug Therapy
Female
Hemorrhage
Humans
Leukapheresis*
Leukocytes
Leukostasis
Male
Partial Thromboplastin Time
Platelet Count
Prothrombin Time
Retrospective Studies