Leukopheresis for profound hyperleukocytosis

Seble S. Chekol, Bhavana Bhatnagar, Ivana Gojo, John R. Hess

Research output: Contribution to journalArticle

Abstract

Background: Leukocytoreduction by leukopheresis is recommended for hyperleukocytosis with leukemia, especially when accompanied by neurologic or respiratory symptoms. A single 1-1.5 blood volume leukocytopheresis is expected to reduce the leukocyte count by 30-60%. Case Report: A 35. year old man presented with a 2. month history of hearing and visual loss and was found to have chronic myelogenous leukemia (CML) in chronic phase with 700,000 WBC/μL. The blast count was 1%. The spleen was markedly enlarged. He was referred for leukocytopheresis and treatment of his leukemia. Despite the extremely high white cell count, he had a hematocrit of 24, platelets of 161,000/μL, and normal lung, liver and renal function. Results: A 15. L leukocytapheresis was performed with a Cobe Spectra with the removal of 1.86. L of bloody fluid with a hematocrit of 10% and a leukocrit of 28%. The blood white cell count decreased from 599,000 to 498,500/μL, and the patient felt better. He was started on hydroxyuria and 8. days later his WBC was 7000/μL. Discussion: The patient's oncologists were initially concerned by the only 17% reduction in his white cell count. However, calculations based on his hematocrit and leukocrit in blood and waste bag suggested that he was 140% blood volume expanded by his leukemia and that the cytopheresis removed about half of the extra volume along with an additional 250. mL of leukocytes, about 35% of his pre-treatment WBC volume. The case and its implications for similar patients are discussed.

Original languageEnglish (US)
Pages (from-to)29-31
Number of pages3
JournalTransfusion and Apheresis Science
Volume46
Issue number1
DOIs
StatePublished - Feb 2012
Externally publishedYes

Fingerprint

Leukapheresis
Hematocrit
Leukemia
Blood Volume
Leukocyte Count
Cell Count
Leukemia, Myeloid, Chronic Phase
Hearing Loss
Nervous System
Leukocytes
Blood Platelets
Spleen
Kidney
Lung
Liver
Therapeutics

Keywords

  • Blood cell removal
  • Blood viscosity
  • CML
  • Leukostasis
  • White cell apheresis

ASJC Scopus subject areas

  • Hematology

Cite this

Leukopheresis for profound hyperleukocytosis. / Chekol, Seble S.; Bhatnagar, Bhavana; Gojo, Ivana; Hess, John R.

In: Transfusion and Apheresis Science, Vol. 46, No. 1, 02.2012, p. 29-31.

Research output: Contribution to journalArticle

Chekol, Seble S. ; Bhatnagar, Bhavana ; Gojo, Ivana ; Hess, John R. / Leukopheresis for profound hyperleukocytosis. In: Transfusion and Apheresis Science. 2012 ; Vol. 46, No. 1. pp. 29-31.
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