leukapheresis A laboratory procedure in which white blood cells are separated from a sample of blood. This may be done to decrease a very high white blood cell count in individuals with cancer (leukemia) or to remove white blood cells for transfusion. In the case of cancer, usually hematological malignancies such as acute leukemias, there are white blood cell counts high enough to cause hemostasis and "sludging" in the capillaries. This can effect retinal vasculature leading to vision changes, pulmonary vasculature leading to shortness of breath from decreased efficiency in oxygen exchange, as well as other organ systems such as the brain which would become clinically apparent with neurolical deterioration of a patient from cerebrovascular compromise.
Leukapheresis reduces early mortality in patients with acute myeloid leukemia with high white cell counts but does not improve long- term survival.
This occurred in 6/21 (29%) for gravity leukapheresis and 9/27 (33%) for filtration leukapheresis.
Thus, gravity leukapheresis appears to be as efficacious as filtration leukapheresis for treating granulocytopenic febrile patients, with the added advantages of availability to any blood bank without new equipment, of having platelets as by-products, and of not requiring donor heparinization.
Current evidence suggests that there are no major safety concerns for the use of leukapheresis for inflammatory bowel disease, and that it may be beneficial in carefully selected patients with ulcerative colitis.
Leukapheresis using centrifugation removes a proportion of neutrophils and lymphocytes.
In the same trial, adverse events were described as moderate or severe in 12% (5/42) of patients treated with leukapheresis: 2 patients had a headache, 1 patient had toxic shock, 1 patient had chest pain and 1 patient had anaemia.
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