The influence of high proportion of white blood cell deduction therapy on blood coagulation function by continuous flow centrifuge for blood component separator

Abstract

Objective To explore the impact of high proportion of white blood cell (WBC) deduction therapy on comprehensive coagulation index and plasma fibrinogen concentration detected by continuous flow centrifuge (CFC) in blood component separator in patients with hyperleukocytic leukemia (HLL).Methods With ACD-A preservation solution as blood anticoagulant,the WBC deduction therapy was performed in patients with HLL by the mononuclear cell (MNC) program of the COBE Spectra type of CFC.In each cycle of treatment,2.5-3.0 times of total blood volume (TBV) was circulated,and the WBC suspension with 20 ％-25 ％ TBV was collected.56 times of WBC deduction treatment were performed in 39 patients with HLL.Results For a single treatment,(233.63±27.41) minutes was spent,(12 268.77±1 978.25) ml blood was circulated,(991.04±185.06) ml of ACD-A preservation solution was used,and (922.89±213.26) ml of WBC suspension were collected,in which WBC count was 551.05×109/L (396.76×109/L,756.45×109/L),the total number of WBC was 491.52×109 (341.53×109,754.51×109).Before treatment and after treatment,the WBC counts were 233.30× 109/L (163.62× 109/L,367.05 × 109/L) and 167.34× 109/L (94.40× 109/L,260.06× 109/L) (s =765,P＜ 0.001),PT were (15.69±2.82) s and (15.81±2.71) s (t =1.25,P＞ 0.05),aPTT were (39.22±8.15) s and (39.87±7.97) s (t =1.96,P ＞ 0.05),TT were (17.35±1.73) s and (17.48±1.57) s (t =1.77,P ＞ 0.05),Fbg concentration were (2.91±1.00) g/L and (2.61±0.81) g/L (t =7.49,P ＜ 0.001),respectively.Conclusions By high proportion(with 20 ％-25 ％ TBV) of WBC depletion therapy for patients with HLL,the WBC load was significantly reduced,as well as the concentration of plasma fibrinogen was deceased,too,while the reduction level of plasma fibrinogen concentration is in the compensatory range of body normal hemostatic function.There is no significant influence on comprehensive coagulation indexes (including PT,aPTF and TT) of endogenous and exogenous coagulation activity by WBC depletion therapy for patients with HLL. Key words: Blood component separator; Leukemia; Leukapheresis; Coagulation