Therapeutic leukapheresis in a tertiary care hospital: A case series

Abstract

Patients presenting with hyperleukocytosis secondary to acute leukemia, with total leukocyte count or blast count more than 100,000/μL are often considered for leukapheresis, especially if clinical signs of leukostasis are present. Leukostasis is often associated with high morbidity and mortality in patients with leukemic processes. The main goal of management of hyperleukocytosis and/or leukostasis is to reduce the blast count before initiation of chemotherapy. Leukapheresis is often used prophylactically to prevent leukostasis or to provide symptomatic relief. We, as transfusion medicine specialists, present our experience of doing therapeutic leukapheresis in patients presenting with hyperleukocytosis with or without presenting features of leukostasis.

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

“…In the literature, Ganzel et al stated that leukapheresis is recommended to be performed on all patients with hyperleukocytosis either with or without clinical manifestations to prevent imminent symptoms of leukostasis and to reduce the severity of tumor lysis syndrome. 2 , 35 However, the effect of leukapheresis in improving mortality outcome is still controversial with studies producing conflicting results. 13 , 15 , 16 , 19 , 36 For example, a retrospective study by Malkan et al with 28 AML subjects consisting of 10 subjects receiving leukapheresis and 18 subjects not receiving leukapheresis with outcome of early deaths in 15 days post-treatment, showed no difference in early death, although the study stated that leukapheresis can effectively lower plasma leukocytes.…”