Hyperleukocytosis and leukocytapheresis in acute leukaemias: experience from a single centre and review of the literature of leukocytapheresis in acute myeloid leukaemia. Issue 6 (6th August 2013)

• Record Type: Journal Article
• Authors: Bruserud, Ø.; Liseth, K.; Stamnesfet, S.; Cacic, D. L.; Melve, G.; Kristoffersen, E.; Hervig, T.; Reikvam, H.
• Is Part Of: Transfusion medicine. Volume 23:Issue 6(2013)
• Page Start: 397
• Page End: 406
• Publication Date: 2013-08-06
• Subjects: Blood -- Transfusion -- Periodicals; 615.39
• DOI: 10.1111/tme.12067
• Languages: English
• ISSNs: 0958-7578

Abstract

<abstract abstract-type="main" id="tme12067-abs-0001"> <title>SUMMARY</title> <sec id="tme12067-sec-0001" sec-type="section"> <title>Background</title> <p id="tme12067-para-0001">Hyperleukocytosis is usually defined as leukocyte count >100 × 10<sup>9</sup> L<sup>−1</sup> and can be seen in newly diagnosed leukaemias. Hyperleukocytic leukaemia is associated with a risk of organ failure and early death secondary to leukostasis. Mechanical removal of leukocytes by the apheresis technique, leukocytapheresis, is a therapeutic option in these patients.</p> </sec> <sec id="tme12067-sec-0002" sec-type="section"> <title>Methods</title> <p id="tme12067-para-0002">During a 16‐year period, 16 patients were treated with leukocytapheresis (35 apheresis procedures) for hyperleukocytosis/leukostasis. We present our experience, and in addition we review previous studies of hyperleukocytosis/leukocytapheresis in patients with acute myeloid leukaemia (AML).</p> </sec> <sec id="tme12067-sec-0003" sec-type="section"> <title>Results</title> <p id="tme12067-para-0003">We used a highly standardised approach for leukocytapheresis in leukaemia patients with hyperleukocytosis. The average leukocytapheresis number for each patient was 2·2 (range 1–6). Median leukocyte count before apheresis was 309 × 10<sup>9</sup> L<sup>−1</sup> (range 104–935); the mean leukocyte count reduction was 71%, corresponding to a mean absolute reduction of 219 × 10<sup>9</sup> L<sup>−1</sup>. No serious side effects were seen during or immediately after apheresis.</p> </sec> <sec id="tme12067-sec-0004" sec-type="section"> <title>Conclusions</title> <p id="tme12067-para-0004">The data suggest that our standardised technique for leukocytapheresis effectively reduced the peripheral blood leukaemia cell counts. Previous studies in AML also support the conclusion that this is a safe and effective procedure for the treatment of a potentially life‐threatening complication, but apheresis should always be combined with early chemotherapy.</p> </sec> </abstract>