Evaluation of therapeutic leukapheresis in hyperleukocytic leukemias.
- Author:
Yong Wha LEE
1
;
Gyu Young JEONG
;
Hong Hoe KOO
;
Hong Ghi LEE
;
Dae Won KIM
Author Information
1. Department of Clinical Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Hyperleukocytosis;
Therapeutic leukapheresis;
Leukostasis
- MeSH:
Age Distribution;
Diagnosis;
Dyspnea;
Headache;
Humans;
Leukapheresis*;
Leukemia*;
Leukemia, Myeloid, Acute;
Leukocyte Count;
Leukocytes;
Leukostasis;
Male;
Mortality;
Platelet Count;
Precursor Cell Lymphoblastic Leukemia-Lymphoma;
Risk Factors
- From:Korean Journal of Blood Transfusion
1998;9(2):219-226
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Leukemia with hyperleukocytosis is risk factor for early mortality and morbidity. Therepeutic leukapheresis has been recognized as the choice of treatment modality to prevent leukostatic complications by selective removal of abnormal leukocytes. METHODS: We analyzed the clinical and laboratory data in total of 44 therapeutic leukapheresis performed at Samsung Medical Center in 31 patients (15 males, 16 females) with hyperleukocytic leukemias from March 1, 1995 to August 31, 1998. The change of laboratory findings related to therapeutic leukapheresis as well as the correlation between preprocedural and postprocedural hematologic parameters, the degree of leukoreduction and clinical efficacy were evaluated. RESULTS: The age distribution was from 6 months to 77 years with the 35 years of mean age. The most common diagnosis of patients who were performed therapeutic leukapheresis was acute myeloblastic leukemia (15/32, 46.9%) followed by acute lymphoblastic leukemia (9/32, 28.1%), and major leukostatic symptoms were dyspnea and headache. The mean leukocyte count before leukapheresis were 167,400/microliter and the mean leukoreduction per procedure was 50,080/microliter (30.3%). The changes of hemoglobin and platelet count were not significant. The efficacies of therapeutic leukapheresis were 66.7% in acute myeloblastic leukemia, 44.4% in acute lymphoblastic leukemia and 37.5% in other leukemia patients. Patients with low initial leukocyte count and blast count or low final leukocyte count showed higher clinical improvement rate than patients without those parameters. CONCLUSION: The present study for therapeutic leukaphresis indicate that it is relatively safe and can be used to relieve leukostatic symptoms and improve clinical status in leukemic patients.
