Yamauchi K, Noguchi K, Shimizu M, Nagao T, Arimori S
Tokai J Exp Clin Med. 1982 Nov;7(6):655-60.
It is well known that adult T-cell leukemia (ATL) is usually refractory to chemotherapy, acute or subacute in clinical course and is accompanied by lethal infections, suggesting a deficiency in cellular immunity. Chemotherapy makes the deficiency in cellular immunity worse, and this is followed by lethal infections. Therefore, a patient with ATL underwent leukapheresis on an IBM 2997 cell separator. A total of 22.3 x 10(11) leukemic T cells was removed. Removal of a large number of leukemic T cells was not associated with improvements in clinical symptoms except for skin eruption, but was not complicated by lethal infections. The peripheral leukocyte count after the 14th procedure began to increase over the prepheresis levels. In the course of frequent leukapheresis, leukemic meningitis occurred. Intrathecal injections of a small dose of antileukemic agents resulted in a rapid reduction of the leukemic T cell count and improvements in clinical symptoms. However, the patient died from cryptococcal sepsis. The survival time was 10 months from clinical onset, 9 months from diagnosis, 9 months from leukapheresis and 5 months from chemotherapy. From this experience, it appears that long-term repeated leukapheresis can decrease lethal infections and extend the survival time.
众所周知，成人T细胞白血病（ATL）通常对化疗耐药，临床病程呈急性或亚急性，且伴有致命感染，提示存在细胞免疫缺陷。化疗会使细胞免疫缺陷恶化，进而导致致命感染。因此，一名ATL患者在IBM 2997细胞分离器上进行了白细胞分离术。共去除了22.3×10¹¹个白血病T细胞。大量白血病T细胞的去除除了皮疹外，并未使临床症状得到改善，但也未并发致命感染。第14次操作后的外周白细胞计数开始超过采血前水平。在频繁进行白细胞分离术的过程中，发生了白血病性脑膜炎。鞘内注射小剂量抗白血病药物导致白血病T细胞计数迅速下降，临床症状改善。然而，患者死于隐球菌败血症。从临床发病起存活时间为10个月，从诊断起为9个月，从白细胞分离术起为9个月，从化疗起为5个月。从这一经验来看，长期反复进行白细胞分离术似乎可以减少致命感染并延长存活时间。
