Effect of prophylactic leukapheresis on early mortality and overall survival in acute leukemia patients with hyperleukocytosis.

INTRODUCTION Hyperleukocytosis has been associated with early mortality owing to the presence of complications including leukostasis, TLS and DIC. Leukapheresis is a fast and effective cytoreductive procedure that removes leukocytes from the peripheral circulation. METHODS This single-center, retrospective and observational study included 32 patients diagnosed with acute leukemia and underwent leukapheresis due to hyperleukocytosis between 2014 and 2020. This study primarily aimed to investigate the effect of prophylactic leukapheresis on early mortality and OS. RESULTS In the symptomatic group, 7 and 2 patients died in the first and second weeks, respectively. In the prophylactic leukapheresis group, 2 and 1 patients died in the first and second weeks(P=0.792), respectively. OS was significantly longer in the prophylactic leukapheresis group(P=0.004). DISCUSSION The leukapheresis procedure appears to be effective on early mortality and OS. Initiation of prophylactic leukapheresis prior to the appearance of leukostasis symptoms is effective on OS and possibly early mortality.