Leukapheresis is a leukemia treatment that filters white blood cells out of the blood. While not a standard chronic myelogenous leukemia treatment, leukapheresis nonetheless plays an important role in leukemia management, especially during pregnancy. Leukapheresis also allows for the harvesting of healthy stem cells directly from a donor's blood during peripheral blood stem cell transplantation.
Leukapheresis uses a machine to remove white blood cells, or leukocytes, from peripheral blood (blood in the circulation system). The procedure takes between three to four hours.
During leukapheresis, blood is removed through an intravenous needle in one arm and delivered to the leukapheresis machine. The machine separates the blood into its different parts, including red blood cells, platelets and white blood cells. The white blood cells are removed, and the remainder of the blood returned to the body through an intravenous needle in the other arm.
Some people accumulate high levels of abnormal white blood cells before chronic myelogenous leukemia diagnosis. Excess amounts of white blood cells can cause blood flow problems to the brain, eyes and lungs. Leukapheresis can quickly remove white blood cells and reduce the risk of these complications.
In some cases, leukemia treatment begins with a chemotherapy drug called hydroxycarbamide (or hydroxyurea). Leukapheresis may be used in combination with chemotherapy drugs to further lower the number of leukemia cells in the blood.
Leukemia treatment options are limited if the patient is pregnant. Imatinib is the preferred CML treatment, but its safety for use in pregnant women remains undetermined. Chemotherapy drugs and interferon therapy may also pose risks for the fetus. Leukapheresis offers a way to control CML progression until after birth, when other treatment options can resume.
Despite its ability to reduce white blood cells, leukapheresis remains a little-used option for chronic myelogenous leukemia treatment. This is because white blood cell levels rise rapidly after leukapheresis, and leukapheresis procedures must be repeated every one to three weeks to provide effective leukemia treatment.
Compared to other chronic myelogenous leukemia treatments, leukapheresis is both costly and time intensive. Because of this, leukapheresis is often ruled out the treatment in favor of other, equally effective treatment options.
Leukapheresis has one other role to play in leukemia treatment. Peripheral blood stem cell transplantation gathers stem cells from a donor's blood. Stem cells harvested using leukapheresis are frozen until the patient is ready for stem cell transplantation. The donor may take medications prior to leukapheresis to maximize the amount of circulating stem cells.
Ault, P.; Cortes, J. (2010). Planned pregnancy for a patient with chronic myeloid leukemia. Retrieved September 27, 2010, from http://www.ispub.com/journal/the_internet_journal_of_oncology/volume_7_number_2_31/article/planned-pregnancy-for-a-patient-with-chronic-myeloid-leukemia.html.
Leukemia and Lymphoma Society. (2009). About CML. Retrieved September 27, 2010, from http://cml.leukemia-lymphoma.org/CMLApp/Controller?action=loadContent
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