Abstract
Therapeutic leukapheresis is a rapid and effective method to reduce early mortality of patients with hyperleukocytic leukaemia (HLL). However, few studies on factors influencing the efficiency have been reported. In this study, 67 cases who underwent leukapheresis were retrospectively analysed and factors related to the collection efficiency of leukapheresis (CEWBC) were also evaluated. Paired t test showed that there was a significant decrease in statistics of white blood cell (WBC) counts after apheresis. The results of two independent samples nonparametric test suggested that WBC counts, platelet (PLT) counts, haematocrit (HCT), hemoglobin (HGB), serum chlorine (Cl) and globulin (GLB) before leukapheresis correlated with the CEWBC. Multiple linear regression analysis with background stepwise variable selection indicated that only WBC and HCT before leukapheresis had an influence on CEWBC significantly. Kaplan-Meier analysis and Cox regression model indicated that lymphocyte (LY) and mean corpuscular hemoglobin (MCH) pre-apheresis as independent factors significantly affected the prognostic survival of patients with HLL. Moreover, platelets and red blood cell were contaminated in the product of leukapheresis. It is an urgent problem to be solved in order to realise higher efficacy and higher purity of WBC collection to improve the survival of patients with HLL through optimising instruments.
Highlights
Leukaemia is a kind of abnormal haematopoietic stem cell clone of hyperplastic disease
The collection of red blood cell (RBC) counts with mean of 0.60 × 1012/l and PLT counts with mean of 271.00 × 109/l were contaminated in the collected product of leukapheresis
Therapeutic leukapheresis has an important significance for patients with hyperleukocytic leukaemia, which has been used to achieve more rapid cyto-reduction with the potential to reduce tumour lysis syndrome
Summary
Leukaemia is a kind of abnormal haematopoietic stem cell clone of hyperplastic disease. Hyperleukocytosis is one of the high-risk types and defined as peripheral blood leukocyte counts exceeding 50–100 × 109/l1 It is characterised by abnormal intravascular leukocyte aggregation and increase of blood viscosity, which results in stasis in the smaller blood vessels[2]. Leukapheresis is a symptomatic treatment of hyperleukocytosis in acute and chronic leukaemias, and is used to decrease the number of white blood cell quickly for the treatment of patients with HLL in clinic[11,12], which is the preferred measure in reducing the early mortality of hyperleukocytosis[13,14]. Is a kind of simple mechanical removal that can relieve the damage of the leukaemia cells for patients and provide opportunity for late treatment, especially for the elderly patients who cannot tolerate chemotherapy, which is an important measure to reduce early mortality[7,15,16]. We investigated the factors influencing therapeutic leukapheresis in patients presenting with hyperleukocytic leukaemia
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