Leukapheresis Therapy of Chronic Lymphocytic Leukemia

The effects of repeated leukapheresis with the IBM Blood Cell Separator were assessed in 13 patients with chronic lymphocytic leukemia (CLL). Five patients had from 14 to 25 leukaphereses at intervals ranging from 7 to 33 days. The median total number of lymphocytes removed was 18.0 x 10¹¹ (range 11.9 x 10¹¹-26.6 x 10¹¹). Two of these patients had a decrease in lymphocyte count and in lymphadenopathy. One of the above and eight additional patients had intensive leukapheresis therapy consisting of five procedures per week for 1-4 wk. The median total number of lymphocytes removed from these patients was 11.34 x 10¹¹ (range 3.30 x 10¹¹-47.4 x 10¹¹). Eight of these patients had a decrease in lymphocyte count, five in spleen size, eight in lymph node size, seven in bone marrow infiltration, and one in liver size. Lymphocyte counts before beginning leukapheresis therapy ranged from 20,500 to 684,000 (median 70,900). The median lymphocyte count on completion of treatment was 19,200 (range 6,590-40,000). After leukapheresis therapy, the median doubling time of the lymphocyte count was 71 days (range 29-118 days). In addition to demonstrating a significant proliferative component in CLL, the objective regression of disease in ten of the 13 patients suggests that leukapheresis is a potentially useful treatment for CLL.