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

Abstract

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.

Keywords:

• Leukapheresis
• hyperleukocytic leukemia
• clearance efficiency

Author contributions

XZ, YT, ZZ and CR designed the study; XZ, YT, JS and YF contributed to the data collection, data analysis and manuscript writing; HM contributed to the data analysis and manuscript revision; LB, XL, ZL, ZZ and CR contributed to patient management; LB, ZL, LD, FG, TL, JZ, HC, QL, ZZ performed the leukapheresis procedures; this research was supported by CR. All authors agreed on the content of the submitted manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the Key R&D Program of Jiangsu Province [BE2019798], Jiangsu Provincial Key Medical Center [YXZXA2016002] and Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD).