Leukapheresis

What is leukapheresis?

Leukapheresis is a procedure healthcare providers use to remove white blood cells from your blood. They do this by taking blood from your bloodstream and processing it to separate white blood cells from red blood cells, plasma and platelets in your blood. They then return your blood back to your bloodstream.

Providers may do leukapheresis to ease symptoms that happen when you have abnormal white blood cells that are multiplying uncontrollably. Leukapheresis is also performed to collect your blood and bone marrow stem cells to help rebuild your bone marrow after receiving chemotherapy for certain blood cancers.

Leukapheresis doesn’t cure blood disorders or blood cancer. Providers typically combine leukapheresis with other treatments.

What is leukapheresis used for?

Healthcare providers use leukapheresis for several reasons:

• You have acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL) or chronic lymphocytic leukemia (CLL), and your provider recommends leukapheresis as an initial treatment.
• You have too many white blood cells in your body that are clogging your blood stream, increasing your risk for heart trouble.
• You’re going to have treatment that requires healthy white blood cells, such as CAR T cell therapy.
• You’re going to undergo a stem cell or bone marrow transplant to treat certain lymphomas or multiple myeloma.
• You’ve been selected as a stem cell or bone marrow donor for someone undergoing for the treatment of certain leukemias.

What happens before I have leukapheresis?

Your healthcare provider may do several tests including:

• Blood tests. In addition to checking your white blood cells, your provider will check on your red blood cells and platelets.
• Electrolyte tests.
• Tests to check your kidney and liver function.
• Blood coagulation tests.

You should wear comfortable clothes and have something to read or watch during the procedure, as leukapheresis takes up to a few hours.

What happens while I have leukapheresis?

Your healthcare provider will make you comfortable in a bed. They place two intravenous lines in your arms. One IV line removes your blood, and the other returns blood to your bloodstream. Sometimes, providers use a single large catheter called a central line that contains both IVs. Providers place it near your neck or under your collarbone.

Leukapheresis may take at least two to three hours to complete. During the procedure, you may notice numbness or tingling in your hands and feet and around your mouth. These feelings are signs that your calcium levels are dropping. Your provider can add calcium to your IV feed to manage those sensations.

What happens after I have leukapheresis?

Your healthcare provider will monitor you for signs of low blood volume or other side effects. They may take blood tests. Depending on the results, they may recommend a blood transfusion to replace red blood cells and platelets.

Will I need additional treatment after I have leukapheresis?

Yes. Healthcare providers do leukapheresis to reduce unusually high levels of white blood cells. When collecting blood stem cells, you may need several leukapheresis sessions to reach a certain stem cell target.

Is leukapheresis harmful?

Most treatments have some side effects, but it’s rare for someone to have serious side effects from leukapheresis. For example, sometimes people develop anemia after leukapheresis removes red blood cells. It’s important to remember your healthcare provider will monitor the process.

What are the most common side effects of leukapheresis?

Potential side effects include:

• Hypocalcemia: This condition happens when you have lower than normal calcium in your blood. The leukapheresis process may remove calcium. Providers treat this side effect with intravenous calcium.
• Anemia: Anemia happens when you don’t have enough red blood cells or your red blood cells are damaged. The leukapheresis process sometimes causes people to lose red blood cells.
• Thrombocytopenia: This condition happens when you have low platelet levels. Platelets help your blood to clot. Low levels may cause unusual or excessive bleeding.

What are leukapharesis advantages?

Leukapheresis can be a life-saving way to reduce serious symptoms that happen when you have a very high number of white blood cells. This procedure quickly reduces the number of white blood cells so your provider can begin other treatments. It also allows for the collection of bone marrow stem cells and their use to promote bone marrow recovery after high doses of chemotherapy for certain blood cancers.

What is the recovery time?

You should plan to take it easy for the first day or so after treatment.

When should I see my healthcare provider?

If you’re receiving leukapheresis, you’re probably being treated for a blood cancer or blood disorder. You should call your provider any time:

• You have a fever of 100.4 F (38 C). This may be a sign of infection.
• You have redness/drainage/pain at your central line’s site indicating either an infection or a clot.
• You notice your symptoms getting worse or changing.

A note from Cleveland Clinic

Leukapheresis is most commonly used to collect blood stem cells to be used as part of stem cell/bone marrow transplant in the treatment of certain blood cancers. It’s also used to collect certain immune cells (CAR T cells) to treat blood cancers. Leukapheresis is an additional treatment that healthcare providers may use to urgently treat certain leukemias by reducing the number of white blood cells in your blood. They do leukapheresis by removing your blood, processing it to separate your white blood cells, and then returning your blood to your bloodstream.