Strauss R A, Gloster E S, McCallister J A, Jimenez J F, Neuberg R W, Berry D H
Med Pediatr Oncol. 1985;13(6):346-51. doi: 10.1002/mpo.2950130609.
Early and effective cytoreduction for high peripheral white blood cell counts in pediatric patients with acute leukemia may be helpful in preventing complications secondary to hyperviscosity. It also may be a useful adjunct to systemic chemotherapy. As an alternative to automated apheresis for this purpose, manual exchange transfusion is efficacious and does not require hemapheresis instrumentation and disposables and the related special staff. Two patients, a neonate with acute myeloblastic leukemia and a white blood cell count of 422.2 k/microliter as well as a 2 1/2-year-old with an admission diagnosis of acute promyelocytic leukemia and a white blood cell count of 617.4 k/microliter, underwent manual exchange hemotherapy for acute cytoreduction. The procedures were tolerated well, and significant leukocyte removal was achieved, with the respective leukocyte reductions being 81.1 and 68.7%. The techniques available for pediatric cytoreduction are compared, with emphasis on their efficiency and safety and appropriateness for very small children.
对于急性白血病患儿高外周血白细胞计数进行早期有效的细胞减灭术，可能有助于预防高黏滞血症继发的并发症。它也可能是全身化疗的有用辅助手段。作为为此目的进行自动血细胞分离术的替代方法，手工换血疗法有效，且不需要血液分离仪器、一次性用品及相关专业人员。两名患者，一名患有急性髓细胞白血病的新生儿，白细胞计数为422.2×10³/微升，另一名2岁半的患儿，入院诊断为急性早幼粒细胞白血病，白细胞计数为617.4×10³/微升，接受了手工换血疗法进行急性细胞减灭。这些操作耐受性良好，实现了显著的白细胞清除，白细胞分别减少了81.1%和68.7%。对可用于儿科细胞减灭的技术进行了比较，重点关注其效率、安全性以及对非常小的儿童的适用性。
