Fluctuations in the Peripheral Blood Leukocyte and Platelet Counts in Leukocytapheresis in Healthy Volunteers

Abstract

Leukocytapheresis (LCP) for the treatment of patients with diseases that involve an abnormal autoimmune reaction aims to improve the condition of the patient's pathology and to correct imbalances in immunological regulation mechanisms by removing the responsible leukocytes from the peripheral blood. To clarify the mechanism of therapeutic effect, LCP was conducted in healthy volunteers to investigate changes in peripheral blood leukocyte and platelet counts over time during the treatment. The subjects were 10 healthy male volunteers. LCP was performed once in each volunteer for 3,000 ml of blood volume. The peripheral blood counts decreased significantly, reaching a minimum of 20.0% of the baseline number of leukocytes, 10.1% of the baseline number of neutrophils, and 40.3% of the baseline number of lympho-cytes. The number of removed leukocytes was about 6.6 × 10 9 cells, including about 3.5 × 10 9 neutrophils, as well as about 5.0 × 10 11 platelets. After the completion of LCP, the peripheral leukocyte levels increased transiently (overshoot), and at 2 h after the completion of the treatment, they reached 193.4% of the baseline value. Since LCP is capable of reducing the peripheral blood leukocyte count over a short period of time, its impact on peripheral blood is great. In addition, in view of the overshoot phenomenon and the appearance of immature granulocytes, the LCP may affect not only the peripheral blood, but also the bone marrow pool, the marginal pool, and the leukocytes present in the tissues.

Recruitment of immature neutrophils in peripheral blood following leukocytapheresis therapy for rheumatoid arthritis

“…In our preliminary analyses of blood lymphocyteand monocyte-subsets using monoclonal antibodies against CD3, CD4, CD14, CD19, CD45RA, CD45RO, CD11a, CD11b, CD49d, CD62L, and IL-10 in RA patients, the post-LCAP/pre-LCAP ratios of the CD191 cell counts were consistently smaller than those of the CD31 cell counts (data not shown), in accordance with previous observations of LCAP in healthy volunteers [16].…”

“…Various proportions of metamyelocytes and myelocytes were found in the post-LCAP peripheral blood of the patients (0-1% and 0-4% respectively, of the total leukocyte counts), similar to the results of a previous study on LCAP in healthy volunteers [16].…”

“…The use of LCAP with a polyester-fiber-column eliminates close to 100% of neutrophils and monocytes and a majority of lymphocytes from the blood that is passed through the column; a large number of neutrophils, but not monocytes or lymphocytes, are immediately recruited into the peripheral blood [5,16].…”

Leukocytapheresis for the treatment of acute exacerbation of idiopathic interstitial pneumonias: a pilot study

“…This is similar to the previous studies in patients with rheumatoid arthritis and ulcerative colitis and healthy volunteers (23)(24)(25). It has been reported that the peripheral blood platelets were removed while passing through the column (26).…”

Microarray analyses of peripheral whole blood cells from ulcerative colitis patients: Effects of leukocytapheresis

“…During LCAP, most of the leukocytes are removed by a filter during extracorporeal circulation. This treatment is associated with rebound leukophilia in response to transient leukopenia (49,50), indicating a rapid cell release response from the reticuloendothelial system. Therefore, this drastic change in gene expression may be partly explained by the replacement of activated leukocytes with new and naïve ones originating from the marginated pool and/or bone marrow.…”