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KMID : 0387720140250020132
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Korean Journal of Blood Transfusion
2014 Volume.25 No. 2 p.132 ~ p.140
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Clinical Effects and Safety of Therapeutic Leukapheresis in Hyperleukocytosis
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이세나:Lee Se-na
공정희:Kong Jung-hee/엄현석:Eom Hyeon-Seok/이혜원:Lee Hye-Won/박현진:Park Hyeon-Jin/손지연:Sohn Ji-Yeon/공선영:Kong Sun-Young
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Abstract
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Background:Therapeutic leukapheresis is the cytoreduction procedure performed before chemotherapy in patients with hyperleukocytosis for prevention of complication. However, there have been clinical concerns about bleeding tendency due to anticoagulant used during the procedure. The aim of our study was to compare the clinical characteristics and hematological parameters before and after therapeutic leukapheresis in order to evaluate its effect on bleeding tendency and to provide a guideline for treatment strategy.
Methods:The clinical data for 39 procedures of therapeutic leukapheresis performed on 17 patients with hyperleukocytosis from May 2005 to October 2013 at the National Cancer Center were reviewed retrospectively.
Results:The patients consisted of 11 males and six females. The mean age was 41 years old (range, 8∼74). The mean number of therapeutic leukapheresis per patient was two (range, 1∼4). Clinical symptoms improved in 14 patients (82%) after therapeutic leukapheresis and three patients (18%) were not yet to improve. The mean WBC count was significantly reduced by 32.6% (±17.4) after therapeutic leukapheresis, from 250,146/μL (±117,000) to 174,702/μL (±104,700) (P＜0.001). The mean volume of single removal was 298 ml with 4.25×1011/L (±1.54) WBCs. After therapeutic leukapheresis, the mean platelet count showed a decline from 85×109/L (±43) to 71×109/L (±26). However, the prothrombin time (PT) and activated partial thromboplastin time (aPTT) did not show a significant increase (PT, P=0.637; aPTT, P=0.054).
Conclusion:Therapeutic leukapheresis is demonstrated as an effective and safe treatment that can improve symptoms and reduce leukocytes in hyperleukocytosis.
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KEYWORD
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Therapeutic leukapheresis, Leukostasis, Hyperleukocytosis
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