PMID- 37033185
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230411
IS  - 2296-2360 (Print)
IS  - 2296-2360 (Electronic)
IS  - 2296-2360 (Linking)
VI  - 11
DP  - 2023
TI  - Repeated small-volume exchange transfusion for hyperleukocytosis in pediatric 
      acute leukemia: A retrospective analysis.
PG  - 1155481
LID - 10.3389/fped.2023.1155481 [doi]
LID - 1155481
AB  - INTRODUCTION: Leukapheresis reduces hyperleukocytosis in children with acute 
      leukemia. Although the usefulness of this procedure is under debate, a repeated 
      small-volume exchange transfusion along with leukapheresis yielded satisfactory 
      results. METHODS: Forty-seven patients with acute leukemia [32 acute lymphocytic 
      leukemia (ALL) and 15 acute myeloblastic leukemia (AML)] were enrolled between 
      January 2017 and June 2022 and underwent repeated small-volume exchange 
      transfusion. The following were measured: demographic and clinical 
      characteristics, time of the procedure, PWBC (peripheral white blood cell) count, 
      hemoglobin, platelet count, blood biochemistry, electrolytes, coagulation, 
      leukostasis, TLS (tumor lysis syndrome), DIC (disseminated intravascular 
      coagulopathy), adverse events (AEs), and serious AEs (SAEs). RESULTS: The 
      demographic and clinical characteristics were not significantly different between 
      ALL and AML patients, but differences were observed in PWBC counts (424.2 +/- 135.6 
      vs. 223.8 +/- 58.0 x 109/L). The procedures needed 3-8 processes, and the average 
      procedure time was not significantly different between ALL and AML. The PWBC 
      count gradually reduced to <100 x 109/L; hemoglobin, platelet count, K+, Na+, and 
      Ca2+ were unchanged. Alanine aminotransferase, aspartate aminotransferase, total 
      bilirubin, blood urea nitrogen, creatinine, troponin-I, creatine kinase-MB, 
      prothrombin time, and activated partial thromboplastin time maintained normal or 
      recovered from abnormal ranges. The manifestations of leukostasis, TLS, and DIC 
      improved or disappeared. No AEs and SAEs occurred. The required total blood 
      volume was based on initial PWBC count, manifestations of leukostasis, and age. 
      CONCLUSIONS: Our finding suggests that repeated small-volume exchange transfusion 
      is effective and safe for treating hyperleukocytosis in children with acute 
      leukemia.
CI  - (c) 2023 Zhang, Lin and Huang.
FAU - Zhang, Dongxiu
AU  - Zhang D
AD  - Department of Pediatrics, the Second Affiliated Hospital and Yuying Children's 
      Hospital, Wenzhou Medical University, Wenzhou, China.
FAU - Lin, Hailong
AU  - Lin H
AD  - Department of Pediatrics, the Second Affiliated Hospital and Yuying Children's 
      Hospital, Wenzhou Medical University, Wenzhou, China.
FAU - Huang, Leting
AU  - Huang L
AD  - Department of Hematology and Oncology, the Second Affiliated Hospital and Yuying 
      Children's Hospital, Wenzhou Medical University, Wenzhou, China.
LA  - eng
PT  - Journal Article
DEP - 20230322
PL  - Switzerland
TA  - Front Pediatr
JT  - Frontiers in pediatrics
JID - 101615492
PMC - PMC10073680
OTO - NOTNLM
OT  - exchange transfusion
OT  - hyperleukocytosis
OT  - leukapheresis
OT  - leukemia
OT  - leukostasis
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/04/11 06:00
MHDA- 2023/04/11 06:01
PMCR- 2023/03/22
CRDT- 2023/04/10 03:50
PHST- 2023/01/31 00:00 [received]
PHST- 2023/02/27 00:00 [accepted]
PHST- 2023/04/11 06:01 [medline]
PHST- 2023/04/10 03:50 [entrez]
PHST- 2023/04/11 06:00 [pubmed]
PHST- 2023/03/22 00:00 [pmc-release]
AID - 10.3389/fped.2023.1155481 [doi]
PST - epublish
SO  - Front Pediatr. 2023 Mar 22;11:1155481. doi: 10.3389/fped.2023.1155481. 
      eCollection 2023.