Korean J Blood Transfus.  1998 Dec;9(2):219-226.

Evaluation of therapeutic leukapheresis in hyperleukocytic leukemias

• Lee YW
• Jeong GY
• Koo HH
• Lee HG
• Kim DW

Abstract

BACKGROUND
Leukemia with hyperleukocytosis is risk factor for early mortality and morbidity. Therepeutic leukapheresis has been recognized as the choice of treatment modality to prevent leukostatic complications by selective removal of abnormal leukocytes.
METHODS
We analyzed the clinical and laboratory data in total of 44 therapeutic leukapheresis performed at Samsung Medical Center in 31 patients (15 males, 16 females) with hyperleukocytic leukemias from March 1, 1995 to August 31, 1998. The change of laboratory findings related to therapeutic leukapheresis as well as the correlation between preprocedural and postprocedural hematologic parameters, the degree of leukoreduction and clinical efficacy were evaluated.
RESULTS
The age distribution was from 6 months to 77 years with the 35 years of mean age. The most common diagnosis of patients who were performed therapeutic leukapheresis was acute myeloblastic leukemia (15/32, 46.9%) followed by acute lymphoblastic leukemia (9/32, 28.1%), and major leukostatic symptoms were dyspnea and headache. The mean leukocyte count before leukapheresis were 167,400/microliter and the mean leukoreduction per procedure was 50,080/microliter (30.3%). The changes of hemoglobin and platelet count were not significant. The efficacies of therapeutic leukapheresis were 66.7% in acute myeloblastic leukemia, 44.4% in acute lymphoblastic leukemia and 37.5% in other leukemia patients. Patients with low initial leukocyte count and blast count or low final leukocyte count showed higher clinical improvement rate than patients without those parameters.
CONCLUSION
The present study for therapeutic leukaphresis indicate that it is relatively safe and can be used to relieve leukostatic symptoms and improve clinical status in leukemic patients.

Keyword

Hyperleukocytosis; Therapeutic leukapheresis; Leukostasis

MeSH Terms

Age Distribution
Diagnosis
Dyspnea
Headache
Humans
Leukapheresis*
Leukemia*
Leukemia, Myeloid, Acute
Leukocyte Count
Leukocytes
Leukostasis
Male
Mortality
Platelet Count
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Risk Factors