Biological Effects of Repeated Leukapheresis of Patients With Chronic Myelogenous Leukemia

Fifteen patients with chronic myelogenousleukemia were managed only with repeated leukapheresis for up to 26 mo. Ateach procedure approximately 10 liters ofblood were processed with a continuous-flow blood cell separator over a 3-hr period. Five patients had intermittent leukapheresis (1-2 procedures/wk), and ten ofthem had one or more series of intensiveleukapheresis (4-5 procedures/wk). Addition of hydroxyethyl starch to the extracorporeal circuit was found to increase theremoval of leukocytes fourfold. With intensive leukapheresis the leukocyte countdecreased 80%, and the platelet count decreased 54% (mean values). With intermittent leukapheresis the correspondingfigures were 70% and 35%. Thrombocytopenia was never clinically significant. All15 patients experienced symptomatic improvement, and those with organomegalyhad decrease in the size of the spleen andliver. Leukapheresis was not associatedwith morbidity, except that anemia became more severe and required periodictransfusions of packed red blood cells.Patients managed with leukapheresis didnot enter bone marrow remission, andtransformation of CML into blastic crisiswas not prevented or delayed.

Submitted on February 17, 1973 Revised on April 30, 1973 Accepted on May 14, 1973