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Leukapheresis: Revolutionizing Acute Myeloid Leukemia TreatmentAshley Janosko and Pamela Keller

A BREAKDOWN BLOODRed Blood Cells Platelets and

PlasmaWhite Blood Cells

• Oxygen carriers• Deliver

hemoglobin for tissue repair

• Lack of red blood cells leads to fatigue and shortness of breath

• Platelets clot hemoglobin cells to form scar tissue

• Plasma is the liquid that carries necessary nutrients throughout the body

• Produce antibodies needed to fight disease

• Have ability to differentiate between native and alien tissue

ACUTE MYELOID LEUKEMIA• Attacks bone marrow where white blood cells are formed• Creates uncontrollable amounts of malformed (cancerous) white

blood cells• Overcrowded blood stream leads to organ failure, infection,

hemorrhage, and eventually, death

LEUKAPHERESIS

PROCEDURE DIAGRAMS

Average AML Patient

Red Blood Cells 40%Slight decrease in cells, overall lower

percentage

Platelets 5%Slight decrease in cells, overall lower

percentage

Plasma 54%Slight decrease in cells, overall lower

percentage

White Blood Cells 1% 30%

Blood Component Percentage

Step 1: Blood Collection• Dual Needle Process: one needle in each arm• The first needle collects blood and transports it to the

centrifugation chamber of the Leukapheresis Machine

Step 2: Blood Centrifugation• Blood is thinned with citrate for more effective separation• Blood components are separated by densities• White blood cells take up a very small section—an aspiration

device is placed at their precise height for better collection

Step 3: COBE Spectra Filtration• Specialized membrane with small tubes large enough to let red

blood cells through, but not white blood cells • Further, heightened separation of white blood cells • Added pressure can possibly clog tubes

Step 4: Blood Return• Blood without white blood cells is returned to the patient• There is still citrate in the blood which can possibly harm the

patient• Saline is pumped in to eliminate some symptoms• Patient is given donor white blood cells to prevent disease Step 2: Blood Centrifugation Step 3: COBE Spectra

Filtration

RESEARCH TIMELINE

SUSTAINABILITY (OF LEUKAPHERESIS)

Year Study

2000

Studied patients with AML and hyperleukocytosis (high levels of white blood cells), and showed that combined treatment with leukapheresis and chemotherapy works better. White blood cell count was significantly reduced in 60% of patients.

2002

Studied the effect of large volume leukapheresis on children diagnosed with AML that weighed under 44 pounds. The results showed that treating children in this manner leads to severe side effect and minimal health improvements.

2007-2009

Studied AML patients over 2 years, half of which were treated with a combination of leukapheresis and chemotherapy. The other half was treated with just chemotherapy. It was determined that after 21 days, patients treated with leukapheresis had a better chance of survival. After it’s completion, this study influenced many hospitals to include leukapheresis in their treatment plans.

By being a sustainable process, leukapheresis greatly improves patient’s quality of life.

Benefits• Shortens treatment time• Allows for freer lifestyle• Lower in cost• Less risk

Downfalls• Large amounts of blood thinner put

into the body• No movement during the

procedure• Healthy white blood cell

destruction