Effects of Leukapheresis on Hemostatic Function in Patients with Hyperleukocytic Leukemia.
10.19746/j.cnki.issn.1009-2137.2022.02.007
- Author:
Yu-Qing TU
1
,
2
,
3
,
4
;
Yi FAN
1
,
2
,
3
,
5
;
Tie-Mei SONG
1
,
2
,
3
,
6
;
Zi-Ling ZHU
1
,
2
,
3
,
4
;
Yu-Feng FENG
1
,
2
,
3
,
4
;
Li-Jun DAI
1
,
2
,
3
,
4
;
Hui-Rong CHANG
1
,
2
,
3
,
4
;
De-Pei WU
1
,
2
,
3
,
4
Author Information
1. Department of Hematology, The First Affiliated Hospital of Soochow University
2. Jiangsu Institute of Hematology
3. National Clinical Research Center for Hematologic Diseases
4. Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou 215006, Jiangsu Province, China.
5. Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou 215006, Jiangsu Province, China,E-mail: yifan@suda.edu.cn.
6. Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou 215006, Jiangsu Province, China,E-mail: suzhoustm@163.com.
- Publication Type:Journal Article
- Keywords:
chinese disseminated intravascular coagulation diagnostic scoring system;
hemostatic function;
hyperleukocytic leukemia;
leukapheresis
- MeSH:
Acute Disease;
Blood Coagulation;
Blood Coagulation Tests;
Hemorrhage;
Hemostatics;
Humans;
Leukapheresis/methods*;
Leukemia, Myeloid, Acute/therapy*
- From:
Journal of Experimental Hematology
2022;30(2):361-366
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To analyze and compare the effects of leukapheresis on hemostatic function in patients with hyperleukocytic leukemia.
METHODS:A total of 139 patients with AML, ALL and CML who underwent leukapheresis from June 2009 to February 2020 and did coagulation test before and after operation were included in this study. The clearance efficiency of each group and the difference among three groups were evaluated, as well as hemostatic function including platelet counts, coagulation indicators, CDSS score and incidence of adverse events. The difference of hemostatic function caused by leukapheresis in different leukemia patients were compared.
RESULTS:After leukapheresis, the WBC counts were decreased significantly in the three groups of patients (P<0.001), and the clearance efficiency was highest in ALL patients. However, the platelet counts also were decreased significantly (AML:P＜0.001, ALL: P＜0.001, CML: P＜0.01) in the three groups of patients, particularly for acute leukemia patients with a positive correlation with WBC clearance efficiency(r=0.284). After leukapheresis, fibrinogen decreased, PT and APTT prolonged. For acute leukemia patients, higher CDSS score was related to an elevated incidence of bleeding events (P<0.05).
CONCLUSION:Leukapheresis is an effective method to decrease the leukemic burden, but it is necessary to monitor the impact on hemostatic function. It is recommended to assess the CDSS socre for acute leukemia patients, in order to identify the predictive value for bleedings.
