Leukapheresis for chronic lymphocytic leukemia

Sometimes very high numbers of leukemia cells in the blood cause problems with normal circulation. Chemotherapy may not lower the number of cells until a few days after the first dose. In the meantime, leukapheresis may be used before chemotherapy. In this procedure, the patient's blood is passed through a special machine that removes white blood cells (including leukemia cells) and returns the rest of the blood cells and plasma to the patient. This treatment lowers blood counts right away. The effect is only for a short time, but it may help until the chemotherapy has a chance to work.

A person having leukapheresis can lie in bed or sit in a reclining chair. Two IV lines are required —- the blood is removed through one IV, and then is returned to the body through the other IV. Sometimes, a single large catheter is placed in the neck or under the collar bone for the pheresis —- instead of using IV lines in the arms. This type of catheter is called a central line and has both IVs built in. Leukapheresis is not painful, but it can be hard to stay sitting or lying down in the same place for 2 or 3 hours. Also, sometimes calcium levels can drop on pheresis, causing numbness and tingling (especially in the hands and feet and around the mouth) and sometimes painful muscle spasms. These can easily be treated by giving the patient calcium.

Leukapheresis works quickly to get the leukemia cells down. However, without further treatment to kill the cancer cells (like chemotherapy), the cell count will go back up again. Leukapheresis may be given to help the patient until chemotherapy has a chance to work.