A STUDY ON EFFECTIVENESS OF LEUKEPHERESIS IN PATIENTS WITH HYPERLEUKOCYTIC LEUKEMIAS

Abstract

Background: Thrombosis is a common complication of hyperleukocytic leukemias. Purpose: To access features of leukostasis, effectiveness of leukopheresis in terms of reduction of WBC, and biochemistry indicators in hyperleukocytic leukemias. Patients and methods: An intervention study was carried out on 112 CML patients treated with leukopheresis in Hai Phong Vietnam - Czech friendship hospital from 7/2017 to 3/2019. Results: (1) Clinical symptoms of leukostatsis: (a) Percentage of symptoms: headache/dizziness: 38,0%; visual impairment/hearing loss: 2,0%; splenic pain/infarct: 12,0%; priapism: 2,0%; leukostasis related pulmonary distress syndrome: 2,0%; CNS hemorrhage: 2,0%. (2) Effectiveness of leukopheresis in term of reduction of WBC, and biochemistry indicators in hyperleukocytic leukemias: (a) WBC reduced significantly after leukopheresis and after 24 hours: CML: 304, 219 and 198 G/l; AML: 295, 206 and 194 G/l; ALL: 342, 207 and 185 G/l, respectively (with P<0,01); (b) Cytoreduction effectiveness after leukopheresis in CML, AML and ALL after 24 hours are: 34,7%; 34,2% and 45,9% respectively. (3) Change of blood uric acid and LDH concentrations after leukopheresis: (a) Uric acid concentration reduced significantly for males and females after leukopheresis; (b) LDH concentration reduced significantly (CML: 3.129 and 1.892 U/l; AML: 2.589 and 1.491 U/l; ALL: 2.992 and 1712 U/l (P<0,01) before and after leukopheresis, respectively (with P<0,01). Conclusion: Leukopheresis is an effective supportive treatment for hyperleukocytic leukamias.