EUH Krakow Conference: What are the indications for leukopheresis?

The Bottom Line: The primary indication for leukopheresis is leukostatis, which is seen most frequently in CML and acute leukemia patients, especially AML. Leukopheresis is also occasionally performed in ALL and CLL.

Reference: Ganzel C, Becker J, Mintz PD, et al. Hyperleukocytosis, leukostasis and leukapheresis: Practice management. Blood Reviews. 2012 May; 26(3):117-122. doi:10.1016/j.blre.2012.01.003.

Summary: The goal of leukapheresis is to reduce the peripheral WBC count. This can decrease the acute symptoms of leukostasis, prevent the development of leukostasis in patients with hyperleukocytosis and avoid or reduce the severity of tumor lysis syndrome and DIC. There are some reports of it as a chronic treatment for CLL and CML. Additionally, leukopheresis is a unique indication for management of a new diagnosis of CML during pregnancy, in order to prevent the exposure of the fetus to cytotoxic drugs and to imatinib.

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