Korean J Med.  1998 Nov;55(5):960-964.

Leukapheresis with high dose hydroxyurea in the management of lower leg artery obstruction in Chronic Myelogenous Leukemia

• Lim CS
• Lee SO
• Kwak JY
• Yim CY

Abstract

There was no specific criteria of white cell count to determine the therapy of hyperleukocytosis in chronic myelogenous leukemia (CML). Therapeutic leukapheresis usually indicated in acute myelogenous leukemia with over 100,000/mm3 of white blood cell, leukocyte infiltration and leukostasis with over 100,000/mm3 of white blood cell, and hairy cell leukemia with no response to drug and splenectomy. Leukapheresis can reverse the hyperleukocytic syndrome rapidly, be used immediately without having to wait for the result of allopurinol to reduce the risk of uric acid nephropathy and decrease the tumor cell mass so as to minimize the extent of cytolysis- induced hyperuricemia, hyperkalemia and hyperphosphatemia. We report a case of 56-year-old man presented right lower leg pain, gait disturbance who was diagnosed CML 4 years before. He showed right popliteal artery obstruction in doppler sonogram and immediatly started leukapheresis. After two therapeutic leukapheresis, symptoms were improved and popliteal blood flow was improved by follow-up doppler sonogram. As a result, we consider that leukapheresis without use of anticoagulant or thrombolytic agents is effective therapy in CML associated leukocytosis and vascular obstruction.

Keyword

Leukapheresis; Leukostasis; CML; artery obstruction

MeSH Terms

Allopurinol
Arteries*
Cell Count
Fibrinolytic Agents
Follow-Up Studies
Gait
Humans
Hydroxyurea*
Hyperkalemia
Hyperphosphatemia
Hyperuricemia
Leg*
Leukapheresis*
Leukemia, Hairy Cell
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*
Leukemia, Myeloid, Acute
Leukocytes
Leukocytosis
Leukostasis
Middle Aged
Popliteal Artery
Splenectomy
Uric Acid
Allopurinol
Fibrinolytic Agents
Hydroxyurea
Uric Acid