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September 1981

Chronic Granulocytic Leukemia With Respiratory Distress: Efficacy of Emergency Leukapheresis

Author Affiliations

From the Departments of Medicine (Drs Karp and Cornell) and Pathology (Dr Beck), Dartmouth-Hitchcock Medical Center, Hanover, NH. Dr Karp is now with Sidney Farber Cancer Institute, Boston. Dr Beck is now with Tufts-New England Medical Center, Boston.

Arch Intern Med. 1981;141(10):1353-1354. doi:10.1001/archinte.1981.00340100109024

• In the absence of preexisting pulmonary disease, progressive respiratory failure caused by leukostasis associated with uncontrolled chronic granulocytic leukemia developed in two patients. The conditions of both patients improved dramatically with aggressive leukapheresis. Clinical improvement correlated with decreased pulmonary wedge pressure, while vascular volume remained constant. Continuous-flow cell separation removed numerous immature myeloid cells, replaced them with oxygen-carrying erythrocytes, and maintained a constant blood volume. The course of these two patients demonstrates the use of continuous-flow leukapheresis in an intensive care unit to reduce leukocyte count and manifestations of leukostasis rapidly, while improving the oxygen-carrying capacity of blood, without exposing the patients to dangerously large shifts in fluid volume.

(Arch Intern Med 1981;141:1353-1354)

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