Rapid Cytoreduction in Acute Leukemia

Abstract

A patient with acute myelogenous leukemia and symptoms of cerebral leukostasis failed to respond to initial chemotherapy. Reduction in blast count from 220,000/microliter to 40,000/microliter was accomplished over a five hour period by leukapheresis using an intermittent flow cell separator, and symptomatic improvement was dramatic. The technique is simple and rapidly effective and may prove a useful adjunct in the treatment of patients with acute leukemia and high blast counts.

CML in pregnancy: A case report using leukapheresis and literature review

“…Leukapheresis is primarily used in leukostasis (symptomatic hyperleukocytosis) but it has occasionally shown to be efficient in maintaining the pregnancy in CML [8,9]. Published literature demonstrates successful use of leukapheresis in only few cases of CML complicating pregnancy [10,11].…”

Therapeutic leukapheresis for hyperleukocytosis in acute myelocytic leukemia

“…They are usually critically ill and white counts must be rapidly lowered [7,8]. Leukapheresis is a safe procedure which mechanically reduces the white count rapidly, following which chemotherapy can safely be administered [9,10]. Patients were initially leukapheresed in order to provide cells for investigational studies.…”

Therapeutic Cytapheresis Using the Fenwal CS-3000 Blood Cell Separator

“…Significant morbidity has also documented with the use of drugs which cause rapid cell lysis in pa tients with a large tumor burden, resulting in lactic acidosis [28], disseminated intravas cular coagulation [29], hyperuricemia with renal failure [30], and hypocalcémie tetany [31]. Reports of successful initial treatment of leukemic patients with symptoms of leu kostasis using intermittent-flow centrifuga tion [4] as well as rapid mechanical platelet reduction in patients with polycythemia vera and thrombocytosis [2] suggest that the most effective use of cytapheresis is in the achievement of rapid cytoreduction in leu kemic patients presenting acutely with greatly elevated numbers of circulating leu kocytes or platelets and symptoms referable to these findings. Further controlled clinical trials are necessary in order to establish the role of therapeutic cytapheresis in the treat ment of these patients.…”

“…A meaningful comparison of the results de scribed in these reports with the data we have presented on the CS-3000 is difficult due to the many variables that exist. A review of the literature shows that the use of the Haemonetics model 30 results in a range of reduction of the initial white blood cell count of24-82% per procedure [4,7,16,18], the Aminco Celltrifuge in a range of24-85% [3,6,12,13,19], and the IBM in a range of 16-33% [1,5], We achieved a range of 22-86% with an overall average of 64% reduction of the initial white blood cell count per procedure using the CS-3000 on the leukemic patients. The present study indicates that rapid cytoreduction can be effectively accomplished using the CS-3000 blood cell separator.…”