Leukapheresis for Chronic Lymphocytic Leukemia

Though it's quite rare, sometimes chronic lymphocytic leukemia (CLL) is diagnosed when very, very high numbers of WBCs thicken the blood and cause problems.

Very high numbers of leukemia cells in the blood can cause problems with normal circulation, which can lead to heart failure and breathing problems. Chemotherapy may not lower the number of cells until a few days after the first dose. Because of this time delay, leukapheresis may be used right away − before chemotherapy. In this procedure, your blood is passed through a special machine that takes out the white blood cells (including leukemia cells) and returns the rest of the blood cells and plasma back into your bloodstream.

For this procedure, you can lie in bed or sit in a reclining chair for a few hours. Two intravenous (IV) lines are needed − the blood is removed through one IV, and then returned to your body through the other IV. Sometimes, a single large catheter is put in near 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 into it.

Leukapheresis is not painful, but sometimes calcium levels can drop during the process. This can cause numbness and tingling (especially in the hands and feet and around the mouth) and, rarely, muscle spasms. This can be treated easily with calcium.

Leukapheresis works quickly to get the number of leukemia cells down. Still, without more treatment (like chemotherapy , monoclonal antibodies , or targeted therapy ) to kill the cancer cells, the cell count will go back up again over time.