Safety Of Leukapheresis Research Articles

Effectiveness and safety of leukapheresis in hyperleukocytic leukemias: a retrospective multicenter study

Leukapheresis is an effective adjuvant therapy for leukemia patients with hyperleukocytosis, but few studies have reported recent data with modern modalities and comparisons among different leukemia types. We conducted a retrospective study on leukapheresis among 420 patients with AML, ALL and CML in four local centers. WBC counts decreased significantly (p < 0.001) postleukapheresis in all three cohorts. Clearance efficiency was higher in acute leukemia patients than CML patients (p < 0.01). Concomitant leukocytoreduction drugs improved WBC reduction only in AML patients (p < 0.05). Leukocyte, hemoglobin and platelet levels preleukapheresis might affect the clearance efficiency in AML and/or ALL patients. Hematological toxicities were the major concerns, but most of them were mild, and only 11 patients died of all causes within one week postleukapheresis. In conclusion, leukapheresis can safely reduce the leukemic burden, especially for patients with acute leukemias.

Abstract P3-01-12: Clinical safety of diagnostic leukapheresis as a liquid biopsy to collect circulating tumor cells in primary and metastatic breast cancer patients

Abstract Introduction: The enumeration of circulating tumor cells (CTCs) has been shown to be of prognostic relevance for neoadjuvant, adjuvant and metastatic setting of breast cancer in multiple clinical trials. Moreover, the serial determination of CTCs enables therapy monitoring in the metastatic setting. One major caveat is the low number of CTCs detected by established methods which limits the possibility for further evaluation including phenotyping and genotyping. Therefore, the clinical use of CTCs as liquid biopsy for making therapy decisions is still under discussion. Diagnostic leukapheresis (DLA) has been previously established by our research group and implemented in the workflow for isolation and detection of CTCs enabling a reliable detection of CTCs at high frequency. The aim of this clinical study was to assess the safety of leukapheresis in 39 patients with primary and metastatic breast cancer. Methods: DLA was performed at least 1d before surgery or chemotherapy. A median blood volume of 2.7 L (range, 1.0 L–5.3 L) was processed. Citrate dextrose solution A was used for anticoagulation with ratios ranging from 11:1 to 24:1. Complete blood count as well as measuring blood pressure and heart rate was performed before start of DLA and immediately after DLA. CTCs were enumerated using the CellSearch system. DLA products containing a median number of 1,8x108 MNCs were processed. Results: 41 patients were eligible for DLA. Only in two patients DLA could not be performed due to technical problems. Thirty-nine patients underwent leukapheresis. Twenty-six patients had non metastatic breast cancer. Thirteen patients were diagnosed with metastatic breast cancer. Severe adverse events including hypotension, nauseas, tingling e.g. resulting in interruption of apheresis were not observed. The DLA did not interfere with the start of chemotherapy or surgery. Complete blood count before and after DLA showed statistic significant but clinically irrelevant decrease in numbers of leukocytes, thrombocytes, hemoglobin and the percentage of hematocrit. In 11/21 DLA samples (52%) of patients with primary breast cancer CTCs were detected. Number of CTCs ranged from 1 to 51. In 11/13 DLA samples (85%) of patients with MBC CTCs were detected. Number of CTCs ranged from 1 to 2913. Conclusion: Establishing a routine DLA protocol we demonstrated that this procedure is clinically safe and can be implemented into the clinical workflow of breast cancer patient care. Citation Format: Fehm T, Meier-Stiegen F, Jaeger B, Reinhardt F, Naskou J, Franken A, Neubauer H, Driemel C, Ruckhaeberle E, Niederacher D, Fischer J, Stoecklein N. Clinical safety of diagnostic leukapheresis as a liquid biopsy to collect circulating tumor cells in primary and metastatic breast cancer patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-01-12.

UP-02.069 Safety of Leukapheresis in Advanced Prostate Cancer Patients Receiving Sipuleucel-T

UP-02.069 Safety of Leukapheresis in Advanced Prostate Cancer Patients Receiving Sipuleucel-T

Aféresis leucocitaria en la inducción de la remisión y retirada de corticoides en la colitis ulcerosa corticodependiente

Background Active ulcerative colitis (UC) is characterized by infiltration of neutrophils, monocytes and macrophages in the colonic mucosa. Selective depletion of activated leucocytes by apheresis devices can be an effective treatment to achieve remission in UC, particularly when conventional treatment has failed. Objective To evaluate the efficacy and safety of leukapheresis in remission induction and steroid withdrawal in patients with active steroid-dependent UC. Patients and method Thirteen patients with steroid-dependent UC unresponsive to immunomodulatory agents underwent weekly leukapheresis sessions. The steroid dose was tapered down according to clinical response. Four weeks after the final leukapheresis session, clinical remission (as defined by an inactive modified Truelove activity index and complete corticosteroid withdrawal) and endoscopic remission were evaluated. Results Clinical remission was achieved in 7 (54 %) of 13 patients. Overall efficacy, remission or partial response, was achieved in 77 %. Three patients underwent 2 cycles of 5 sessions each. Endoscopic remission was achieved in 38.4 % of the patients. The procedure was well tolerated. However, there was one case of pneumothorax on central venous catheter insertion after failed peripheral cannulation. Conclusions Leukapheresis is a safe and effective therapeutic option for induction of remission and corticosteroid withdrawal in patients with steroid-dependent UC unresponsive to immunomodulatory therapy.

Safety of leukapheresis in donors and patients with WBC counts greater than 60k

As new protocols are developed and treatment plans change, the demand for higher numbers of donor stem cells for patients has increased. This is especially true for non-myeloablative transplants where a higher cell dose may be needed to assure engraftment. There is a concern for safety in this donor population that elevated white blood cell counts may lead to altered blood flow kinetics, cause shortness of breath, decreased cerebral blood flow, and contribute to cardiac ischemia.