title: Hyperleukocytosis and leukocytapheresis in acute leukaemias: experience from a single centre and review of the literature of leukocytapheresis in acute myeloid leukaemia.
abstract: BACKGROUND
  Hyperleukocytosis is usually defined as leukocyte count >100 × 10(9)  L(-1) and can be seen in newly diagnosed leukaemias. Hyperleukocytic leukaemia is associated with a risk of organ failure and early death secondary to leukostasis. Mechanical removal of leukocytes by the apheresis technique, leukocytapheresis, is a therapeutic option in these patients.
  
  
  METHODS
  During a 16-year period, 16 patients were treated with leukocytapheresis (35 apheresis procedures) for hyperleukocytosis/leukostasis. We present our experience, and in addition we review previous studies of hyperleukocytosis/leukocytapheresis in patients with acute myeloid leukaemia (AML).
  
  
  RESULTS
  We used a highly standardised approach for leukocytapheresis in leukaemia patients with hyperleukocytosis. The average leukocytapheresis number for each patient was 2·2 (range 1-6). Median leukocyte count before apheresis was 309 × 10(9)  L(-1) (range 104-935); the mean leukocyte count reduction was 71%, corresponding to a mean absolute reduction of 219 × 10(9)  L(-1). No serious side effects were seen during or immediately after apheresis.
  
  
  CONCLUSIONS
  The data suggest that our standardised technique for leukocytapheresis effectively reduced the peripheral blood leukaemia cell counts. Previous studies in AML also support the conclusion that this is a safe and effective procedure for the treatment of a potentially life-threatening complication, but apheresis should always be combined with early chemotherapy.
authors.affiliation: Section of Haematology, Department of Clinical Science, University of Bergen; Department of Medicine, Haukeland University Hospital.
authors.forename: Ø
authors.initials: Ø
authors.lastname: Bruserud
authors.forename: K
authors.initials: K
authors.lastname: Liseth
authors.forename: S
authors.initials: S
authors.lastname: Stamnesfet
authors.forename: D L
authors.initials: DL
authors.lastname: Cacic
authors.forename: G
authors.initials: G
authors.lastname: Melve
authors.forename: E
authors.initials: E
authors.lastname: Kristoffersen
authors.forename: T
authors.initials: T
authors.lastname: Hervig
authors.forename: H
authors.initials: H
authors.lastname: Reikvam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007937:Leukapheresis / Q000379:methods* / Q000592:standards; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000473:pathology / Q000628:therapy*; D007958:Leukocyte Count; D007964:Leukocytosis / Q000097:blood / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: acute myeloid leukaemia; hyperleukocytosis; leukaemia; leukostasis