Alcalay D, Deleplanque P, Maubras M A, Guilhot F
Centre Régional de Transfusion Sanguine, Poitiers.
Ann Med Interne (Paris). 1988;139 Suppl 1:53-4.
A 50 year old man with chronic lymphocytic leukemia (CLL) and extreme hyperleukocytosis (600 x 10(9)/liter) presented with a respiratory distress syndrome, congestive heart failure with cardiomegaly, endotoxic shock and anuria. Examination revealed nodes in all areas and hepatosplenomegaly; laboratory studies showed hypoxemia and a chest X-ray diffuse bilateral alveolar infiltrates. He was treated twice by leukapheresis using a cell separator. This procedure removed 10.1 x 10(10) white blood cells with marked clinical improvement and resolution of air-space diseases over the subsequent 48 hours. Despite this unusual indication for leukapheresis in CLL, this procedure may be of value in treating the leukemic phase of CLL with pulmonary leukostasis.
一名50岁慢性淋巴细胞白血病（CLL）患者，白细胞极度增多（600×10⁹/升），出现呼吸窘迫综合征、充血性心力衰竭伴心脏扩大、内毒素性休克和无尿。检查发现全身淋巴结肿大及肝脾肿大；实验室检查显示低氧血症，胸部X线显示双侧弥漫性肺泡浸润。使用血细胞分离机对其进行了两次白细胞去除术治疗。该操作清除了10.1×10¹⁰个白细胞，随后48小时内临床症状显著改善，气腔疾病消退。尽管白细胞去除术在CLL中有这种不寻常的适应证，但该操作对于治疗伴有肺部白细胞淤滞的CLL白血病期可能有价值。
