title: Leukapheresis treatment in elderly acute leukemia patients with hyperleukocytosis: A single center experience.
abstract: OBJECTIVE
  Leukapheresis is an invasive treatment modality used for hyperleukocytosis. Various drugs and fluids are used during the leukapheresis. Aging itself and associated factors such as increased comorbidity, decreased tolerance to drugs, increased drug toxicity give rise to the application of other treatment modalities in elderly patients. Treatment of acute leukemia in the elderly differs from young patients. Consequently, we assumed that outcome, effectiveness, and side effects of leukapheresis treatment used for acute leukemia patients with hyperleukocytosis may be different in elderly compared to younger patients.
  
  
  METHODS
  We retrospectively evaluated a total of 39 patients. Eighteen patients were 65 years and older. Indications for leukapheresis were determined as symptoms of leukostasis and prophylaxis. Acid citrate dextrose-A, calcium gluconate, and plasma were used during the leukapheresis. Age, sex, diagnosis, count, and indications of leukapheresis procedures, leukocyte count, and lactate dehydrogenase level were analyzed at the onset of and after leukapheresis; side effects, causes of death, early and total mortality rates were also analyzed. We compared the two groups with regard to effectiveness, clinical outcomes, and side effects.
  
  
  RESULTS
  There were no statistically significant differences between the two groups with respect to sex, diagnosis, initial leukocyte count, lactate dehydrogenase level, number of leukapheresis procedures, rates of side effects, or early and total mortality (P > 0.05). Leukapheresis treatment was effective in both groups (P < 0.05) and no significant difference was found in its effectiveness between two groups (P > 0.05).
  
  
  CONCLUSIONS
  Leukapheresis is an effective and safe treatment modality in elderly acute leukemia patients with hyperleukocytosis.
authors.affiliation: Hematology Division, Department of Internal Medicine, Inonu University School of Medicine, Malatya, Turkey.
authors.forename: Ilhami
authors.initials: I
authors.lastname: Berber
authors.affiliation: Hematology Division, Department of Internal Medicine, Inonu University School of Medicine, Malatya, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Erkurt
authors.affiliation: Hematology Division, Department of Internal Medicine, Inonu University School of Medicine, Malatya, Turkey.
authors.forename: Irfan
authors.initials: I
authors.lastname: Kuku
authors.affiliation: Hematology Division, Department of Internal Medicine, Inonu University School of Medicine, Malatya, Turkey.
authors.forename: Emin
authors.initials: E
authors.lastname: Kaya
authors.affiliation: Department of Biostatistics and Medical Informatics, Inonu University School of Medicine, Malatya, Turkey.
authors.forename: Harika
authors.initials: H
authors.lastname: Gozukara Bag
authors.affiliation: Hematology Division, Department of Internal Medicine, Inonu University School of Medicine, Malatya, Turkey.
authors.forename: Ilknur
authors.initials: I
authors.lastname: Nizam
authors.affiliation: Hematology Division, Department of Internal Medicine, Inonu University School of Medicine, Malatya, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Koroglu
authors.affiliation: Department of Internal Medicine, Inonu University School of Medicine, Malatya, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Yigit
authors.affiliation: Hematology Division, Department of Internal Medicine, Inonu University School of Medicine, Malatya, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozgul
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D007937:Leukapheresis / Q000379:methods; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000628:therapy; D007958:Leukocyte Count; D007964:Leukocytosis / Q000097:blood / Q000628:therapy*; D018921:Leukostasis / Q000097:blood / Q000628:therapy; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: acute leukemia; elderly patients; hyperleukocytosis; leukapheresis