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.
Highlights
Leukapheresis is a strategy for immediate reduction of cell mass based on the principle of mechanical removal
The presence of each cluster of designation (CD) marker showed no significant association with the white blood cell (WBC) count or blast percentage (Supplementary Table S3)
There have been some studies on the effectiveness of leukapheresis in leukaemia patients
Summary
Leukapheresis is a strategy for immediate reduction of cell mass based on the principle of mechanical removal. Volume, anticoagulant volume, and access lines that might affect the effectiveness of leukapheresis vary between institutions. There is substantial variation in concomitant CTx regimens using hydroxyurea or low-dose CTx a gents[13]. These points could be confounding factors when analysing leukapheresis. AML and ALL are further classified and result in various subgroups that have heterogeneous pathophysiologic mechanisms and a range of p rognoses[14] Given these heterogeneities, comparison of these patients without considering subgroups might cause misleading results. The effectiveness of leukapheresis has been inconsistent in previous studies, but the aforementioned factors may have affected this
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
