title: The effect of volume replacement during therapeutic leukapheresis on white blood cell reduction in patients with extreme leukocytosis.
abstract: BACKGROUND
  Extreme leukocytosis, generally defined as a white blood cell (WBC) count of more than 100 × 10(9) /L consisting largely of blast cells, especially when accompanied by clinical signs and symptoms of leukostasis or hyperviscosity, often predicts a poor clinical outcome in patients with acute leukemia. In this study, we aimed to investigate the effect of volume replacement (VR) during therapeutic leukapheresis (TA) procedure on early mortality rate and WBC reduction.
  
  
  METHODS
  We retrospectively analyzed 29 patients who underwent TA from 2007 to 2011. Fifteen of the patients underwent TA procedure with VR and 14 of the patients underwent TA procedure without VR.
  
  
  RESULTS
  WBC reduction was significantly higher in patients who underwent TA with VR (p < 0.001). Early mortality rate was significantly lower in leukemia patients who underwent TA with VR than in patients who underwent TA without VR (p < 0.01); early mortality rates were 6.7% for 7-day and 13.8% for 100-day survivals. The mortality rates in the TA without VR group, however, were 42.9 and 71.4% for 7- and 100-day survivals, respectively.
  
  
  CONCLUSIONS
  Decreased early mortality rate in TA with VR group may be associated with prompt reduction of WBCs achieved with TA with VR and may also be associated with removal of the cytokines related to leukostasis. TA with VR would give more time for induction chemotherapy and increased overall survival rate.
authors: Department of Hematology, Faculty of Medicine, Harran University, Sanliurfa, Turkey; Stem Cell Transplantation Hospital, Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey; Department of Internal Medicine, Erciyes University, Kayseri, Turkey; Department of Biostatistics, Faculty of Medicine, Erciyes University, Kayseri, Turkey; Department of Hematology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
authors: Fatih
authors: F
authors: Kurnaz
authors: Serdar
authors: S
authors: Sivgin
authors: Cigdem
authors: C
authors: Pala
authors: Rahsan
authors: R
authors: Yildirim
authors: Suleyman
authors: S
authors: Baldane
authors: Leylagul
authors: L
authors: Kaynar
authors: Musa
authors: M
authors: Solmaz
authors: Ahmet
authors: A
authors: Ozturk
authors: Bulent
authors: B
authors: Eser
authors: Mustafa
authors: M
authors: Cetin
authors: Ali
authors: A
authors: Unal
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D007938:Leukemia / Q000097:blood / Q000628:therapy; D047589:Leukocyte Reduction Procedures / Q000379:methods*; D007964:Leukocytosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies