Continuous-flow leukapheresis for rapid cytoreduction in leukemia.

Three patients with leukemia were treated for acute leukostasis using the continuous-flow cell separator. The first patient, treated with a standard procedure sustained only a 14 per cent decrease in leukocyte count even though 50 X 10(10) leukocytes were removed. A more aggressive approach was taken with the second two patients by increasing the rate of leukocyte removal three- to fourfold. In these patients, 100 to 230 X 10(10) leukocytes were removed and prepheresis counts dropped by 48 to 85 per cent. Both had satisfactory clinical response to pheresis. The data suggest that an aggressive pheresis can effectively treat symptoms associated with acute leukostasis. Finally, the continuous-flow cell separator has distinct advantages over the discontinuous-flow separator in patients with small blood volumes.