leukapherese

Leukapheresis is a medical procedure in which white blood cells (leukocytes) are selectively removed from a patient’s blood. The remaining blood components are returned to the circulation. The procedure uses apheresis equipment that relies on centrifugal separation or filtration to isolate the leukocyte layer, after which the other blood components are reinfused. Vascular access is usually via a peripheral vein, but a central venous catheter may be required for higher-volume collections. Anticoagulation with acid-citrate-dextrose or heparin is used to prevent clotting in the extracorporeal circuit. The treatment session typically lasts several hours and may be repeated across consecutive days as needed.

Indications include the rapid reduction of leukocyte burden in severe hyperleukocytosis or leukostasis, particularly in acute leukemia or myeloproliferative disorders, where high white blood cell counts threaten organ perfusion. It is also used to collect peripheral blood stem cells for transplantation (a process sometimes referred to as PBSC collection), and to obtain immune cells such as dendritic cells for immunotherapy.

Risks are generally low but include citrate-related hypocalcemia with tingling or paresthesias, hypovolemia, electrolyte disturbances, hypotension, or bleeding at the access site. In donors, adverse effects are rare but can include transient discomfort, citrate reactions, or infection related to catheter use. Leukapheresis is typically part of a broader treatment plan that may include chemotherapy or mobilizing agents to control disease.