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. 2021 Mar 19;11(1):6426.
doi: 10.1038/s41598-021-85918-8.

The factors influencing clinical outcomes after leukapheresis in acute leukaemia

Howon Lee  1 , Silvia Park  2 , Jae-Ho Yoon  2 , Byung-Sik Cho  2 , Hee-Je Kim  2 , Seok Lee  2 , Dong-Wook Kim  2 , Nack-Gyun Chung  3 , Bin Cho  3 , Kyoung Bo Kim  1 , Jaeeun Yoo  4 , Dong Wook Jekarl  5   6 , Hyojin Chae  1 , Jihyang Lim  7 , Myungshin Kim  1   8   9 , Eun-Jee Oh  1 , Yonggoo Kim  1   8   9
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The factors influencing clinical outcomes after leukapheresis in acute leukaemia

Howon Lee et al. Sci Rep. .

Abstract

Leukapheresis is used for the mechanical removal of leukaemic cells in hyperleukocytosis. However, the effectiveness of leukapheresis remains unclear due to selection and confounding factors in the cohorts. We compared the effectiveness of leukapheresis among the subgroups according to either the 2016 World Health Organization classification or the number of cytogenetic abnormalities with a retrospective, single-centre study from January 2009 to December 2018. Acute myeloid leukaemia (AML, n = 212) and acute lymphoblastic leukaemia (ALL, n = 97) were included. The 30-day survival rates (95% confidence interval, 95% CI) for AML and ALL were 86.3% (81.6-90.9%) and 94.8% (90.3-99.2%), respectively. For AML, 'primary AML with myelodysplasia-related changes' and 'AML with biallelic mutation of CEBPA' showed better 30-day survival outcomes (P = 0.026) than the other subgroups. A higher platelet count after leukapheresis was associated with better 30-day survival in AML patients (P = 0.029). A decrease in blast percentage count after leukapheresis was associated with better 30-day survival in ALL patients (P = 0.034). Our study suggested that prophylactic platelet transfusion to raise the platelet count to 50 × 109/L or greater might improve clinical outcome in AML patients undergoing leukapheresis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart. AML acute myeloid leukaemia, ALL acute lymphoblastic leukaemia, FAB French–American–British, MRC myelodysplasia-related changes.
Figure 2
Figure 2
Changes in CBC parameters before and after leukapheresis in the acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL) groups. Each boxplot represents the range from the 25th to 75th percentile of each group. CBC complete blood cell, WBC white blood cell.
Figure 3
Figure 3
Changes in CBC parameters before and after leukapheresis in the non-CR and CR groups in the acute myeloid leukaemia (AML) group. Each error bar represents the range from the 25th to 75th percentile of each group. CBC complete blood cell, CR complete remission, WBC white blood cell.
Figure 4
Figure 4
Survival among the subgroups according to CBC parameters in the acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL) groups. CBC complete blood cell, WBC white blood cell.
See this image and copyright information in PMC

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