Lab Med Online.  2016 Jul;6(3):159-164. 10.3343/lmo.2016.6.3.159.

Therapeutic Leukapheresis for the Management of Hyperleukocytosis: Ten-year Experience in a Tertiary Care Hospital

• Kim B
• Lee K
• Kim S
• Kim HO

• KMID: 2308731
• DOI: http://doi.org/10.3343/lmo.2016.6.3.159

Abstract

BACKGROUND
Hyperleukocytosis is a medical emergency that is characterized by increased blood viscosity and predisposition to various neurological, pulmonary, and gastrointestinal complications. In addition, patients are at risk of the tumor lysis syndrome because of the increased tumor burden. Therapeutic leukapheresis is an important treatment for these emergent states. In this study, we retrospectively analyzed therapeutic leukapheresis procedures that were performed in our institution during the last 10 yr.
METHODS
We retrospectively analyzed therapeutic leukapheresis procedures conducted from July 2005 to March 2015 at a tertiary care hospital. We present our observations, especially the procedural characteristics and hematological parameters before and after the aforementioned procedures.
RESULTS
Seventy-two patients underwent a total of 146 therapeutic leukapheresis procedures. The average presenting white blood cell (WBC) count was 268×10(3)/µL, and ranged from 54×10(3)/µL to 673×10(3)/µL. After an average of two sessions, a statistically significant drop in the WBC counts was observed. The average WBC removal rates during the initial and entire therapeutic leukapheresis procedures of each patient were 33% and 46%, respectively. The platelet count and hemoglobin concentration were significantly reduced.
CONCLUSIONS
Therapeutic leukapheresis significantly reduces peripheral WBC counts and is a safe and effective procedure for the treatment of hyperleukocytosis.

Keyword

Hyperleukocytosis; Therapeutic leukapheresis; Leukemia

MeSH Terms

Blood Viscosity
Emergencies
Humans
Leukapheresis*
Leukemia
Leukocytes
Platelet Count
Retrospective Studies
Tertiary Healthcare*
Tumor Burden
Tumor Lysis Syndrome

Figure

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  Fig. 1 The distribution of presenting white blood cell counts (×103/µL) according to the patient's diagnosis. Abbreviations: ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; CML, chronic myelogenous leukemia.

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