Abstract:

Objective To determine whether leukapheresis has a favorable impact on hyperleukocytic acute leukemia (HAL) patients with leukostasis,and it has any effects on the disease outcomes of these patients.Methods Clinical data of 66 hyperleukocytic acute leukemia patients were collected. The impact of leukapheresis on leukostasis and peripheral white blood cell count were retrospectively analyzed. Clinical outcomes such as early mortality, complete remission (CR) rate and overall survival (OS) rate were also accessed. Results Leukapheresis can reduce the peripheral WBC count of HAL patients (P=0.000). The time to WBC count declined to 20×10⁹/L in the group with leukapheresis was significantly shorter than that in the group without leukapheresis (P=0.011). As to type I respiratory failure and central nervous system symptoms caused by leukostasis, a significant improvement was revealed in leukapheresis group (P<0.05). There was no significant difference in early mortality between the two groups (P=1.000). The differences in complete relief (CR) rate after the first cycle of induction chemotherapy, CR rate after the second cycle and overall survival between the two groups were not observed (P>0.05). Conclusion Leukapheresis and low-dose chemotherapy could quickly reduce the peripheral WBC counts of HAL patients, and improve type I respiratory failure and central nervous system symptoms due to leukostasis. Leukapheresis did not improve early mortality, CR rate after the first cycle of induction chemotherapy, CR rate after the second cycle and OS of HAL patients.

Key words: hyperleukocytic acute leukemia, leukapheresis, leukostasis