Repeated Leukapheresis of Patients with Chronic Myelocytic Leukemia

Abstract

The technic of plasmapheresis has been employed repeatedly to obtain large numbers of granulocytes from patients with chronic myelocytic leukemia. Up to 20 liters of blood from a single donor could be processed by centrifugation in one week without changes in the patient's clinical condition or his blood proteins as long as the plasma and red cells were both returned. The major limiting factor was the chronic removal of small amounts of red cells with each unit, resulting in decrease in hemoglobin level with intensive and prolonged periods of plasmapheresis. Removal of granulocytes at rates up to 3 × 1011 per day produced little consistent decrease in peripheral white count unless it was continued for a week or more. Plasmapheresis is a safe and relatively simple technic for the collection of large numbers of leukocytes from donors with chronic myelocytic leukemia.

The Transfusion of Leukocytes from Donors with Chronic Myelocytic Leukemia to Patients with Leukopenia*

“…The donors were bled two units at a time up to eight units per day to provide white cells for 118 transfusions to 40 patients with leukopenia, 35 of whom had acute leukemia. While most of the transfusions were given to children, 16 were given to ten adult patients. The white cells were transfused in ACD plasma or as saline concentrates within four hours after they were obtained.…”

Proliferation of Myeloid Cells

“…to 128,000 per mm" (70 ) . With the daily removal of 2.0 to Z.O X 1011 cells from patients with chronic myelocytic leukemia, there was a gradual de crease in white blood count which, however, persisted only for a few weeks after the termination of leukapheresis.…”

Leucocyte Separation and Transfusion

“…Although the earliest attempts to treat neutropenic patients with leucocyte transfusions were reported in 1925, regular clinical trials awaited the development of effective leucapheresis techniques. Processing one or two units of blood at a time, it was shown that up to 3 x I O '~ granulocytes could be removed daily from patients with chronic granulocytic leukaemia (CGL) (Morse et al, 1966). Advances in the technology necessary to permit extended periods of extracorporeal circulation of peripheral blood gave birth to the present generation of continuous flow blood cell separators.…”