Leukapheresis and Hyperleukocytosis, Past and Future

Abstract

Hyperleukocytosis is a hematologic crisis caused by excessive proliferation of leukemic cells and has a relatively high early mortality due to a series of severe complications. Therefore, prompt and effective intervention is required. Leukapheresis performed using apheresis equipment to separate leukocytes from peripheral blood, at the same time returns autologous plasma, platelets and erythrocytes to the patient, is applied clinically for the treatment of hyperleukocytosis. Leukapheresis not only removes excessive leukocytes rapidly and corrects metabolic abnormalities but also alleviates the symptoms of leukostasis. In addition, the procedure of leukapheresis is generally well tolerated. Leukapheresis has become one of the most imperative adjuvant therapies to treat hyperleukocytosis, especially in the patient who was not inappropriate to cytoreduce with Ara-C or hydroxyurea. In this review, we present the background of leukapheresis development and highlight its clinical application in hyperleukocytic leukemia patients.

Targeted Large-Volume Lymphocyte Removal Using Magnetic Nanoparticles in Blood Samples of Patients with Chronic Lymphocytic Leukemia: A Proof-of-Concept Study

“…Future studies must evaluate lymphocyte removal in CCL patients using an extracorporeal device and determine the effectiveness of this method. In theory, antibody-directed lymphocyte reduction may be superior to standard leukapheresis in various states of hyperleukocytosis (not resulting in leukostasis in CLL) as the nanoparticles may be modified according to the patient’s leukocyte surface characteristics allowing for a targeted cell removal as opposed to an unspecific leukocyte depletion [ 15 , 16 ]. Furthermore, the generalizability and transferability of this method to target and remove specific cells in the blood, especially in other types of leukemia, where hyperleukocytosis often results in symptomatic leukostasis, is undoubtedly a strength of this method and opens new medical treatment approaches.…”

RNA profiling of circulating tumor cells systemically captured from diagnostic leukapheresis products in prostate cancer patients

“…The common uses include, but are not limited to, self-MNC preservation, component blood transfusion, etc. [ 26 ]. Several studies have validated and confirmed that DLA followed by conventional CTC capture technologies can significantly increase the CTC yield.…”

The value of leukapheresis for treatment of priapism as presenting feature of chronic myeloid leukemia—Case report and review of literature

“…However, leukapheresis comes with high costs and requires specialized equipment, trained personnel, and need of a central venous catheter, which can cause a delay in treatment. Another disadvantage is the loss of red blood cell and platelets, so its suitability in patients with low Hb or platelets levels is limited [80]. However, we state that the disadvantages do not outweigh the benefits of leukapheresis.…”