A hospital based retrospective study of factors influencing therapeutic leukapheresis in patients presenting with hyperleukocytic leukaemia

Abstract

Therapeutic leukapheresis is a rapid and effective method to reduce early mortality of patients with hyperleukocytic leukaemia (HLL). However, few studies on factors influencing the efficiency have been reported. In this study, 67 cases who underwent leukapheresis were retrospectively analysed and factors related to the collection efficiency of leukapheresis (CEWBC) were also evaluated. Paired t test showed that there was a significant decrease in statistics of white blood cell (WBC) counts after apheresis. The results of two independent samples nonparametric test suggested that WBC counts, platelet (PLT) counts, haematocrit (HCT), hemoglobin (HGB), serum chlorine (Cl) and globulin (GLB) before leukapheresis correlated with the CEWBC. Multiple linear regression analysis with background stepwise variable selection indicated that only WBC and HCT before leukapheresis had an influence on CEWBC significantly. Kaplan-Meier analysis and Cox regression model indicated that lymphocyte (LY) and mean corpuscular hemoglobin (MCH) pre-apheresis as independent factors significantly affected the prognostic survival of patients with HLL. Moreover, platelets and red blood cell were contaminated in the product of leukapheresis. It is an urgent problem to be solved in order to realise higher efficacy and higher purity of WBC collection to improve the survival of patients with HLL through optimising instruments.

Apheresis principles in a patient with chronic myeloid leukemia during pregnancy: challenges in cell separation and assessing transcript levels

“…Along with the measurable reduction in the leukocyte count in peripheral blood, the patient's spleen shrank to normal size. The mean rate of WBC depletion was 19.1%, ranging from 1% to 34% (Table ), consistent with other similar reports using other apheresis devices . After the 20th leukapheresis session, the WBC count was stabilized at less than 100 × 10 9 cells/L (Fig.…”

Leukapheresis Does Not Improve Early Survival Outcome of Acute Myeloid Leukemia with Leukostasis Patients – A Dual-Center Retrospective Cohort Study

“… 2 A retrospective study by Jin et al attempted to seek factors that influence efficacy of therapeutic leukapheresis in patients with hyperleukocytosis leukemia. 29 In the study, the authors found that lymphocyte count, mean corpuscular hemoglobin (MCH), and hematocrit levels prior to apheresis procedures were independent factors affecting survival. 29 From the study by Jin et al, it can be speculated that there may have been a group of patients that received more benefit from leukapheresis based on lymphocyte count, MCH, and hematocrit levels.…”

“…6 Leukapheresis is widely accepted to be very effective in rapid reduction of white blood cell count with up to 70% of leukocytes removed in just a single session. 28,29 However, like all medical treatments and procedures, there are always limitations. The major limitation of leukapheresis is that the procedure does not remove blast cells from bone marrow.…”

Leukocytapheresis in Chronic Myeloid Leukemia With Leukostasis

“…Leukocytapheresis along with hydration may help reduce the risk of TLS and complications associated with hyperviscosity, especially in patients with very high TLC [ 3 ]. Leukocytapheresis leads to rapid cytoreduction and does not affect the coagulation parameters [ 4 ].…”