Table 2.
The Pros and Cons of Leukapheresis
| Author and Year | Advantage | Disadvantage | Perspectives |
|---|---|---|---|
| Powell et al (1991)35 | Leukapheresis could modulate the cell cycle distribution and increase the fraction of leukemia cells in S-phase. | NA | Leukapheresis may increase the efficiency of cytarabine and other S-phase specific agents. |
| Galera et al (2016)39 | Leukapheresis could improve pulmonary leukostasis in pregnant woman without side effect. | NA | Leukapheresis was recommended for the treatment of hyperleukocytosis with neurologic and pulmonary manifestation by ASFA as it could reduce the intravascular leukemic cellular burden rapidly and improve tissue perfusion. |
| Bruserud et al (2012)36 | Leukapheresis was a safe and effective procedure for the treatment of hyperleukocytic leukemia with life-threatening complications and without side effect. | NA | Leukapheresis may have therapeutic effect in hyperleukocytic leukemia patients with leukostasis. The important thing to note was chemotherapy should not be postponed for the prevention of the rapid re-accumulation of blasts. |
| Sung et al (2012)37 Jin et al (2018)34 |
Leukapheresis could reduce the occurrence of renal failure and metabolic derangements with little toxicity on hepatic-renal function | NA | Leukapheresis was safe and efficient in leukoreduction and could be used for the treatment of children and pregnant women with hyperleukocytic leukemia. |
| Giammarco et al (2017)42 | NA | Leukapheresis required specialized equipment and trained personnel. | It may be challenging to perform leukapheresis on large-scale. |
| Allon et al (2007)43 | NA | Leukapheresis required a central venous catheter which hold a high risk of bleeding, thrombosis and catheter-related infection and venous stenosis at the catheter site. | Patients who underwent the treatment of leukapheresis need more intensive care. |
| Punzel et al (2017)46 | NA | Leukapheresis can reduce the number of leukocytes rapidly along with the loss of red blood cell and platelet | Patients who underwent leukapheresis with hemoglobin below 60 g/L or platelet below 30×109/L need be pre-treated with red blood cell or platelet transfusion. |
| Sanz et al (2009)47 | NA | leukapheresis may exacerbate coagulopathy associate with a high risk of death at induction. | Leukapheresis was not recommended for the treatment of acute promyelocytic leukemia. |
Abbreviation: NA, not available.