Leukapheresis

Overview

Leukapheresis is a procedure where healthcare providers remove white blood cells from the bloodstream. This is done by drawing blood, processing it to separate white blood cells from red blood cells, plasma, and platelets, and then returning the remaining blood components to the body. This procedure is often used to alleviate symptoms caused by abnormal white blood cells multiplying uncontrollably, as well as to collect blood and bone marrow stem cells for rebuilding bone marrow after chemotherapy for certain blood cancers.

While leukapheresis is an important medical procedure, it does not cure blood disorders or blood cancer. Instead, it is typically combined with other treatments to manage these conditions effectively.

Reasons for undergoing the procedure

Your healthcare providers utilize leukapheresis for several purposes, including:

• Have an excessive number of white blood cells in your body, which could potentially clog your bloodstream and increase the risk of heart problems.
• Having acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), or chronic lymphocytic leukemia (CLL), your healthcare provider may recommend leukapheresis as an initial treatment option.
• Preparation for a stem cell or bone marrow transplant to treat certain lymphomas or multiple myeloma.
• Selected as a stem cell or bone marrow donor for someone undergoing treatment for certain leukemias
• Undergoing treatment that necessitates healthy white blood cells, such as CAR T cell therapy.

Risk

Most treatments carry some side effects, but serious side effects from leukapheresis are rare. For instance, some individuals may experience anemia after leukapheresis due to the removal of red blood cells. It’s crucial to note that your healthcare provider will closely monitor the procedure.

The potential risk or side effect may include:

• Anemia: Red blood cell deficiencies or damage to the already-existing red blood cells can result in anemia. Certain individuals may undergo a decrease in red blood cells during the leukapheresis procedure.
• Hypocalcemia: The condition is brought on by blood calcium levels that are below normal. You might have calcium taken out of your bloodstream during leukapheresis. Intravenous calcium is used by healthcare providers to manage this side effect.
• Thrombocytopenia: This condition is caused by low platelet counts. Platelets play a crucial role in blood clotting, and reduced levels can lead to excessive or abnormal bleeding.

Before the procedure

Your healthcare provider may conduct several tests, including:

• Blood coagulation tests.
• Blood tests will be conducted to assess not only your white blood cells but also your red blood cells and platelets.
• Electrolyte tests.
• Kidney and liver function test

During leukapheresis, which can last several hours, it’s advisable to wear comfortable clothing and have reading material or entertainment to pass the time.

During the procedure

You will be placed on a bed by your health care provider to guarantee your comfort. Two intravenous lines—one for taking out blood and the other for putting it back into your bloodstream—will be inserted into your arms. As an alternative, they can use a single, large catheter known as a central line, which combines both IV functions and is usually positioned beneath your collarbone or close to your neck.

Usually, leukapheresis takes two to three hours to be completed. You may feel numbness or tingling in your hands, feet, or mouth area during the procedure, this could be a sign of a decrease in calcium levels. Your healthcare provider may use your IV to give you calcium to alleviate these feelings.

After the procedure

Your healthcare provider will monitor you closely for signs of low blood volume or other potential side effects during and after leukapheresis. They may conduct blood tests to assess your condition. Based on the results, they may recommend a blood transfusion to replenish red blood cells and platelets if necessary.

Leukapheresis is a procedure used by healthcare providers to lower abnormally elevated white blood cell counts. It could take several leukapheresis sessions to obtain the desired number of stem cells while harvesting blood stem cells.

Outcome

Leukapheresis is a crucial procedure for alleviating the severe symptoms associated with elevated white blood cell counts. By rapidly reducing these counts, the technique enables healthcare providers to initiate treatment promptly. Additionally, leukapheresis facilitates the extraction of bone marrow stem cells, which is vital for supporting bone marrow recovery following intensive chemotherapy for certain blood cancers.

If you’re undergoing leukapheresis, you’re likely undergoing treatment for a blood cancer or blood disorder. It’s important to contact your healthcare provider immediately if:

• You develop a fever of 100.4°F (38°C), as this could indicate an infection.
• You experience redness, drainage, or pain at the site of your central line, which may suggest either an infection or a clot.
• You observe a worsening or changes in your symptoms.