Leukapheresis and Hyperleukocytosis, Past and Future

Hyperleukocytosis is a hematologic crisis caused by excessive proliferation of leukemic cells and has a relatively high early mortality due to a series of severe complications. Therefore, prompt and effective intervention is required. Leukapheresis performed using apheresis equipment to separate leukocytes from peripheral blood, at the same time returns autologous plasma, platelets and erythrocytes to the patient, is applied clinically for the treatment of hyperleukocytosis. Leukapheresis not only removes excessive leukocytes rapidly and corrects metabolic abnormalities but also alleviates the symptoms of leukostasis. In addition, the procedure of leukapheresis is generally well tolerated. Leukapheresis has become one of the most imperative adjuvant therapies to treat hyperleukocytosis, especially in the patient who was not inappropriate to cytoreduce with Ara-C or hydroxyurea. In this review, we present the background of leukapheresis development and highlight its clinical application in hyperleukocytic leukemia patients.

Automated summary

Hyperleukocytosis is a hematologic crisis characterized by excessive proliferation of leukemic cells, requiring prompt intervention. Leukapheresis can rapidly remove excessive leukocytes, correct metabolic abnormalities, alleviate leukostasis symptoms, and is generally well tolerated. Leukapheresis has become an imperative adjuvant therapy for hyperleukocytosis, especially for patients who cannot undergo cytoreduction with Ara-C or hydroxyurea.