RCE effectively reduces the WBC count and corrects anemia in patients with hyperleukocytosis. (A) Percent WBC count reduction. (B) The difference in percent WBC count change between TLP1/TLP2 (blue filled circles) or TLP/RCE (red filled circles). (C) Micrographs of a Wright's stained peripheral blood smear from a patient with AML with monocytic features (left) and of a Wright's stained smear from the RCE waste bag from the same patient (right), 100× magnification. (D) Percent hematocrit change. (E) Percent change in hematocrit compared with percent reduction in WBC count in patients undergoing RCE either alone or following failed TLP for whom ending hematocrit was deliberately increased. (F) TLP or RCE procedure length. (A,D,F) TLP alone is defined by blue filled circles; paired TLP and RCE by blue and red shapes, with each shape representing an individual patient; and RCE alone by red filled circles. All analyses of variance with multiple comparisons were one-way unless otherwise specified: (A) ∗P = .024, ∗∗P = .0037, ∗∗∗∗P < .0001. (B) ∗∗∗P = .0001 unpaired t test. (D) ∗∗P = .0025, ∗∗∗∗P < .0001. (E) P = .0071, R2 = .47, simple linear regression. (F) ∗∗∗P = .0002, ∗∗∗∗P < .0001. (A,D,F) All comparisons not marked by an asterisk are P > .05.
