Moxey-Mims M M, Luban N L, Bock G H, Ruley E J, Preston K M
Department of Child Health and Development, George Washington University School of Medicine, Washington, D.C.
J Clin Apher. 1988;4(1):47-9. doi: 10.1002/jca.2920040109.
Therapeutic leukapheresis of a 10-year-old girl with adult-type chronic myelocytic leukemia is described. The efficiency of WBC removal was noted to improve significantly after addition of hydroxyethyl starch to the anticoagulant infusion. In fact, the percentage of white cells removed more than doubled (39% vs. 16%) when comparing procedures of similar duration, with and without the sedimenting agent. Of particular interest was the relief of the patient's respiratory distress concomitant with the decline in her leukocyte count, a finding that has not previously been documented in pediatric patients. The arterial oxygen pressure remained greater than 95 mmHg after the procedure with hydroxyethyl starch compared with 70 mmHg after the procedures without it. In addition, her respiratory rate decreased from 70 on admission to the low 20s after the final procedure. Leukapheresis with hydroxyethyl starch was shown to be a safe procedure, and the use of hydroxyethyl starch was shown to be of particular benefit for prevention of prolonged apheresis procedures.
描述了对一名患有成人型慢性粒细胞白血病的10岁女孩进行治疗性白细胞单采术的情况。在抗凝剂输注中添加羟乙基淀粉后，白细胞去除效率显著提高。事实上，在比较使用和不使用沉降剂的类似持续时间的操作时，去除的白细胞百分比增加了一倍多（39%对16%）。特别值得关注的是，随着白细胞计数下降，患者的呼吸窘迫得到缓解，这一发现此前在儿科患者中尚未有记录。与未使用羟乙基淀粉的操作后动脉血氧分压为70 mmHg相比，使用羟乙基淀粉的操作后动脉血氧分压保持在95 mmHg以上。此外，她的呼吸频率从入院时的70次/分钟降至最后一次操作后的20次/分钟出头。结果表明，使用羟乙基淀粉进行白细胞单采术是一种安全的操作，且使用羟乙基淀粉对预防长时间单采术特别有益。
