학술논문

Hyperleukocytosis and leukocytapheresis in acute leukaemias: experience from a single centre and review of the literature of leukocytapheresis in acute myeloid leukaemia.
Document Type
Article
Source
Transfusion Medicine. Dec2013, Vol. 23 Issue 6, p397-406. 10p.
Subject
*LEUCOCYTOSIS
*LEUCOCYTES
*LEUKEMIA
*ACUTE myeloid leukemia
*MULTIPLE organ failure
*CANCER chemotherapy
*DISEASE risk factors
Language
ISSN
0958-7578
Abstract
SUMMARY Background Hyperleukocytosis is usually defined as leukocyte count >100 × 109 L−1 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. Methods 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). Results 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 × 109 L−1 (range 104-935); the mean leukocyte count reduction was 71%, corresponding to a mean absolute reduction of 219 × 109 L−1. No serious side effects were seen during or immediately after apheresis. Conclusions 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. [ABSTRACT FROM AUTHOR]