In some types of leukemia – most often acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) – white blood cells are greatly overproduced, causing a condition known as hyperleukocytosis. In hyperleukocytosis, white blood cells are so thick that they interfere with normal blood flow, causing symptoms in the lungs, brain, eyes, and small blood vessels. In severe cases, hyperleukocytosis can lead to heart failure and serious lung or brain damage.
Leukapheresis is a short-term treatment for hyperleukocytosis that is often performed on an emergency basis. Leukapheresis does not treat the underlying problem – chemotherapy and other medications are needed to kill cancer cells. Leukapheresis limits the amount of white blood cells in the blood, working quickly to relieve symptoms and prevent damage before chemotherapy has had time to work.
What does it involve?
Undergoing leukapheresis is somewhat like receiving a blood transfusion. Two intravenous lines (IVs) will be placed in the arm, or a single large IV called a central line will be placed near the neck. Blood will travel out of one IV into a machine that filters out white blood cells. Filtered blood will then return to your body through the other IV.
Leukapheresis must be received in a dedicated clinical setting. A leukapheresis treatment requires between one and three hours.
The goal of leukapheresis is to reduce levels of white blood cells in the blood, preventing damage and relieving symptoms caused by hyperleukocytosis.
Studies show that leukapheresis is a safe and effective procedure that works quickly to reduce dangerous levels of white blood cells until the effects of chemotherapy manifest.
Leukapheresis may cause a drop in levels of calcium in the blood, causing numbness or tingling in the hands, feet, or mouth. Some people experience muscle spasms. Your doctor may give you a calcium supplement when receiving leukapheresis to avoid these side effects.
Some people may experience dizziness, fainting or nausea during plasma exchange. Eating a meal within two hours before undergoing leukapheresis and drinking extra water help combat these side effects.
A very small number of people experience infections or bleeding due to leukapheresis.
For more details about this treatment, visit:
Leukapheresis for Chronic Lymphocytic Leukemia – American Cancer Society
Treatment to remove abnormal white blood cells (leukapheresis) – Cancer Research UK
A Guide to Leukapheresis: Become an Expert – Physicians Plasma Alliance
Lowering High White Blood Cell Counts (Leukapheresis) – Leukemia & Lymphoma Society
Leukapheresis in patients newly diagnosed with acute myeloid leukemia – Transfusion and Apheresis Science