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. 2017 Jul-Dec;11(2):156-161.
doi: 10.4103/ajts.AJTS_103_16.

Therapeutic leukocyte reduction for acute and chronic myeloid leukemias: A 4-year experience from an oncology center in India

Anita A Tendulkar  1 , Puneet A Jain  1 , Abhaykumar Gupta  1 , Nidhi Sharma  1 , Anisha Navkudkar  1 , Vijaya Patle  1
Affiliations

Therapeutic leukocyte reduction for acute and chronic myeloid leukemias: A 4-year experience from an oncology center in India

Anita A Tendulkar et al. Asian J Transfus Sci. 2017 Jul-Dec.

Abstract

Introduction: Hyperleukocytosis (HL) and leukostasis seen in myeloid leukemias are a medical emergency. We present a case series of ten such patients in a 4-year period. Sixteen therapeutic leukocyte reduction (TLR) were done in ten cases along with other supportive measures. The American Society for Apheresis supports the routine implementation of TLR in cases of HL secondary to myeloid leukemias with signs of leukostasis.

Materials and methods: The procedures were performed on the intermittent flow cell separator after discussion with the treating physician about patient's condition. Clinical, demographic, analytical, and technical variables were reviewed retrospectively and the patients were followed up at the end of 4 years. Descriptive analysis was performed for all variables, and relationships between quantitative variables and categorical variables were determined by applying the Student's t-test.

Results: The mean age of presentation was 34 years. Priapism was the most common symptom followed by respiratory distress and neurological disturbances. After an average of 1.6 TLR procedures, the mean leukocyte count reduction achieved was 39.9% along with symptomatic relief. The mean survival at 4-year follow-up was 12.8 months and the overall mortality was 20%. Acute myeloid leukemia patients presented with lower mean platelet counts compared to chronic myeloid leukemia patients; however, the platelet loss in the final product was minimized.

Conclusion: TLR is a safe and effective therapy for leukoreduction in hematological malignancies in our experience.

Keywords: Hyperleukocytosis; leukemia; leukocytapheresis; therapeutic leukocyte reduction; tumor lysis syndrome.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Layers of red blood cells and leukocytes (buffy coat) after therapeutic leukocyte reduction in an acute myeloid leukemia patient
Figure 2
Figure 2
Layers of red blood cells, leukocytes, and platelets (buffy coat) after therapeutic leukocyte reduction in a chronic myeloid leukemia patient
See this image and copyright information in PMC

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