title: Leukapheresis in management of hyperleukocytosis in children's leukemias.
abstract: We describe 16 leukapheresis (LK) procedures performed in 7 children with different types of leukemia and hyperleukocytosis. We also provide an analysis of previously published experiences of pediatric LK. Median age and body weight of patients were 12.3 years (range, 0.2 to 16.7 y) and 49 kg (range, 5 to 61 kg). Immediate pre-first-LK median white blood cell count was 478×10/L (108×10/L to 988×10/L). All cytoreduction were performed on Cobe Spectra cell separator. Sixty-eight percent of procedures were performed with peripheral veins. Extracorporeal line had been primed with red blood cell for 31% of LK. The median decrease in white blood cell count after each LK was 33% (0% to 69%), and overall decrease after completion of LK procedures was 62% (11% to 94%). Only minor clinical adverse events and no metabolic complication were attributable to LK. No more clinical symptom of hyperleukocytosis was observed after completion of LK procedures. Our findings are consistent with reported results in other pediatric series: LK is a well-tolerated procedure that can be safely performed with an experienced pediatric team even on the smallest children.
authors.affiliation: *CHU de Clermont-Ferrand, Centre Régional de Cancérologie et Thérapie Cellulaire Pédiatrique, Hôpital Estaing †CIC Inserm 501 ‡Clermont Université, Université Clermont1, Faculté de Médecine, Clermont-Ferrand, France.
authors.forename: Victoria
authors.initials: V
authors.lastname: Grèze
authors.forename: Fanny
authors.initials: F
authors.lastname: Chambon
authors.forename: Etienne
authors.initials: E
authors.lastname: Merlin
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Rochette
authors.forename: Florentina
authors.initials: F
authors.lastname: Isfan
authors.forename: François
authors.initials: F
authors.lastname: Deméocq
authors.forename: Justyna
authors.initials: J
authors.lastname: Kanold
mesh_terms: D000293:Adolescent; D049628:Body Size; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007937:Leukapheresis / Q000379:methods*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D015477:Leukemia, Myelomonocytic, Chronic / Q000628:therapy*; D007958:Leukocyte Count; D007964:Leukocytosis / Q000628:therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D016896:Treatment Outcome