Therapeutic leukocytapheresis for leukostasis in chronic lymphocytic leukemia: A case report and literature review

IF 1.4 4区医学 Q4 HEMATOLOGY Journal of Clinical Apheresis Pub Date : 2023-07-30 DOI:10.1002/jca.22082

Thomas Auen DO, Pranav Renavikar MBBS, Esther Habib DO, Scott A. Koepsell MD, PhD

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Abstract

Chronic lymphocytic leukemia (CLL) is a clonal mature B-cell neoplasm with a typically indolent clinical course. Though most clinicians follow these neoplasms through observation alone, an aggressive transformation to prolymphocytic leukemia, diffuse large-B-cell lymphoma (Richter transformation) or classical Hodgkin lymphoma requires immediate attention. We present a case of extreme leukocytosis (>1 million/μL) in a previously diagnosed CLL patient. Due to symptomatic leukostasis, she was started on cytoreductive therapies including leukocytapheresis. After three rounds of leukocytapheresis (LCP) and concurrent chemotherapy, her white blood cell count decreased from a maximum 1262 × 10³/μL to 574 × 10³/μL. To our knowledge, CLL with symptomatic leukostasis that required therapeutic LCP is rarely reported in literature. We propose that therapeutic LCP is of value in such rare, yet dangerous settings like our case.

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治疗慢性淋巴细胞白血病白细胞滞留：病例报告和文献综述

慢性淋巴细胞白血病(CLL)是一种克隆成熟的b细胞肿瘤，具有典型的惰性临床病程。虽然大多数临床医生仅通过观察来追踪这些肿瘤，但侵袭性转化为前淋巴细胞白血病，弥漫性大b细胞淋巴瘤(Richter转化)或经典霍奇金淋巴瘤需要立即注意。我们报告一例极端白细胞增多症(> 100万/μL)在一个以前诊断的CLL患者。由于症状性白细胞淤积，她开始接受细胞减少治疗，包括白细胞清除。经3轮白细胞清除(LCP)和同期化疗后，患者白细胞计数由最高1262 × 103/μL降至574 × 103/μL。据我们所知，需要LCP治疗的CLL伴症状性白细胞淤积在文献中很少报道。我们认为治疗性LCP在像我们这样罕见但危险的情况下是有价值的。

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来源期刊

Journal of Clinical Apheresis 医学-血液学

CiteScore

2.80

自引率

13.30%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Clinical Apheresis publishes articles dealing with all aspects of hemapheresis. Articles welcomed for review include those reporting basic research and clinical applications of therapeutic plasma exchange, therapeutic cytapheresis, therapeutic absorption, blood component collection and transfusion, donor recruitment and safety, administration of hemapheresis centers, and innovative applications of hemapheresis technology. Experimental studies, clinical trials, case reports, and concise reviews will be welcomed.