Asian Journal of Transfusion Science
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Therapeutic leukapheresis as adjunctive therapy in hyperleukocytosis: Experience from a Tertiary Care Hemato-oncology center in South India


1 Department of Transfusion Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham University, Kochi, Kerala, India
2 Department of Clinical Haematology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham University, Kochi, Kerala, India
3 Department of Biostatistics, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham University, Kochi, Kerala, India

Correspondence Address:
Veena Shenoy,
Amrita Institute of Medical Sciences and Research Centre, Ponekkara. P.O, Kochi - 682 041, Kerala
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajts.ajts_41_22

BACKGROUND: The usefulness of therapeutic leukapheresis procedure in patients with hyperleukocytosis (HL) is often debated. This retrospective study was done to determine the effect of therapeutic leukapheresis on hematological parameters in hyperleukocytic patients and to determine the factors affecting the collection efficiency (CE) of the procedure. METHODS: Leukapheresis procedure was performed when the leukocyte counts were >100 × 109/L in the presence of symptoms of leukostasis and/or tumor lysis syndrome. The Cairo and Bishop classification was used to document the presence of tumor lysis syndrome. Apheresis procedural variables were retrieved for patients between August 2017 and March 2021. The CE for the leukocyte depletion procedure was determined. Wilcoxon signed-rank test was used to determine the significance of changes in hematology variables. Pearson's correlation coefficient was computed to test the linear relationship between apheresis procedure-related factors and CE. RESULTS: Sixteen consecutive patients who underwent a total of 22 leukapheresises were included in the study. Leukapheresis yielded a significant reduction in white blood cell (WBC) (51%) and platelet count (24%) with clinical improvement in 75% of patients. No serious adverse events were observed. The volume of WBC removed and preprocedure hematocrit had a positive intermediate correlation with CE. The procedure flow rate negatively affected the CE (r = −0.43). The 30-day mortality was 50% with the median survival time of the entire cohort being 26 (5.8–46) days. CONCLUSION: Leukapheresis was effective in reducing the leukemic cell burden to half in HL patients providing short-term benefits. The CE of apheresis was approximately 20% with only a few variables influencing the efficiency of the procedure.


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2006 - Asian Journal of Transfusion Science | Published by Wolters Kluwer - Medknow
Online since 10th November, 2006