Kasner Margaret T, Laury Adrienne, Kasner Scott E, Carroll Martin, Luger Selina M
Division of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Am J Hematol. 2007 Dec;82(12):1110-2. doi: 10.1002/ajh.21006.
Leukapheresis is often considered in the management of acute myelogenous leukemia (AML) with hyperleukocytosis and its sequelae, including myocardial infarction, pulmonary complications, and stroke. It is utilized on the assumption that leukapheresis improves blood rheology. We present a woman with AML and a history of meningioma encasing her left internal carotid artery. She presented with hyperleukocytosis and symptoms of ischemia. As her white blood cell continued to rise despite initiation of hydroxyurea therapy, she underwent leukapheresis emergently. Transcranial Doppler ultrasound demonstrated increased flow velocities in the left internal carotid and the right middle cerebral arteries, which normalized after leukapheresis. This is the first documentation that leukapheresis, in combination with hydroxyurea, improves cerebral hemodynamics in a patient with AML.
白细胞去除术常用于治疗伴有白细胞增多症及其后遗症（包括心肌梗死、肺部并发症和中风）的急性髓系白血病（AML）。其应用基于白细胞去除术可改善血液流变学这一假设。我们报告一名患有AML且有包裹其左颈内动脉的脑膜瘤病史的女性。她出现白细胞增多症和缺血症状。尽管开始使用羟基脲治疗，但她的白细胞持续升高，因此紧急接受了白细胞去除术。经颅多普勒超声显示左颈内动脉和右大脑中动脉血流速度增加，白细胞去除术后恢复正常。这是首次有文献记载白细胞去除术联合羟基脲可改善AML患者的脑血流动力学。
