Therapeutic leukocytapheresis for leukostasis in chronic lymphocytic leukemia: A case report and literature review.

Abstract

Chronic lymphocytic leukemia (CLL) is a clonal mature B-cell neoplasm with a typically indolent clinical course. Though most clinicians follow these neoplasms through observation alone, an aggressive transformation to prolymphocytic leukemia, diffuse large-B-cell lymphoma (Richter transformation) or classical Hodgkin lymphoma requires immediate attention. We present a case of extreme leukocytosis (>1 million/μL) in a previously diagnosed CLL patient. Due to symptomatic leukostasis, she was started on cytoreductive therapies including leukocytapheresis. After three rounds of leukocytapheresis (LCP) and concurrent chemotherapy, her white blood cell count decreased from a maximum 1262 × 103 /μL to 574 × 103 /μL. To our knowledge, CLL with symptomatic leukostasis that required therapeutic LCP is rarely reported in literature. We propose that therapeutic LCP is of value in such rare, yet dangerous settings like our case.

• Authors: Thomas Auen, Pranav Renavikar, Esther Habib, Scott A Koepsell
• Journal: Journal of clinical apheresis (J Clin Apher) (Jul 30 2023) ISSN: 1098-1101 [Electronic] United States
• PMID: 37519096 (Publication Type: Case Reports)
• Copyright: © 2023 The Authors. Journal of Clinical Apheresis published by Wiley Periodicals LLC.