Emin KAYA, İrfan KUKU, İsmet AYDOĞDU, Mustafa DİKİLİTAŞ, Elmas UZER, M. Ali ERKURT, Mesut ORHAN, Ahmet GÖRGEL, Mustafa ÖZGÜL

Hiperlökositozlu lösemi hastalarımızda terapötik ve proflaktik lökoferez deneyimlerimiz

Akut lösemi hastalarında artmış blastlar, lökostaz yada tümör liziz sendromu gibi ciddi klinik problemlere neden olabilir. Bunların tedavisinde ve/veya önlenmesinde, lökoferez etkili ve hızlı bir tedavi seçeneğidir. Bu çalışmada kliniğimizde artmış lökosit sayıları nedeniyle lökoferez uygulanan 22 hastanın sonuçlan, işlemin etkinliği ve klinik seyrine etkisi açısından değerlendirildi. Lökoferez işlemi, 11 hastaya lökostaz tablosu nedeni terapötik olarak, diğer 11 hastaya ise proflaktik amaçlı uygulandı. Her ild grupta da lökoferez ile ortalama %42'lik lökosit azalması sağlandı. Ancak etkili lökosit azalması sağlanmasına rağmen, terapötik lökoferez uygulanan hastalardan 7'si lökostaz nedeni ile öldü. Sonuçta blast sayısı artmış lösemi hastalarının tanı sırasında proflaktik lökoferezin erken dönemde yapılmasının faydalı olabileceğini düşünüyoruz.

Therapeutic and prophylactic leukapheresis in hyperleukocytositic leukemias; our experiences

Excessive blasts_iiM5atients with acute leukeamia may cause serious problems such as tumour lysis syndrome or luekostasis. LeukapheVesis is effective in prevention and/or treatment of these problems. In this study we evaluated the results /of 22 .patients having hyperleukocytosis and underwent leukapheresis in/"Qİder to evaluate the effectivenes*-o£-tne procedure and its influence on clinical course. While therapeutic leukapheresis was performed to 11 patients, in the remainder prophylactic leukapheresis was performed. An average uf_4z% leucocyte depletion was obtained in (-both group However, despite the significant leucocyte depletion, 7 of the 11 patients who underwent thcratooıiç leukaprteresis have died due to leukostasis. We suggest that prophylactic lueHabheresis performed early qujing the diagnosis may be effective in acute leukeamia patients with hyperleukocytosis.

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