Leukapheresis

What is leukapheresis?  

Leukapheresis is a procedure that removes white blood cells from the blood. It can be used to help treat leukocytosis, a condition that causes a high white blood cell count.

Leukapheresis is a type of apheresis, a procedure to remove a part of the blood. The apheresis machine separates the blood and removes white blood cells. The rest of the blood is returned back to the body through a vein. Only a small part of your child’s blood is out of the body at any time.

Leukapheresis is also known as leukodepletion or white blood cell depletion.

What to expect during leukapheresis  

The process of leukapheresis can take 2 to 4 hours. Your care team will explain what to expect and answer any questions.

Your child will be in bed during the procedure. Have your child wear comfortable, loose-fitting clothing. During the procedure, your child can watch a movie, read, color, or have games or toys that can be played with in the bed.

Your care team decides the best way to access your child’s veins based on the size of their veins and the number of times they may have treatments. The procedure is usually done with 2 lines (double needle procedure). Types of access include:

• Central venous catheter (central line) placed into a large vein in the neck, chest, or groin
• Intravenous (IV) line placed in the arm

Your care team will take steps to reduce the risk of infection. All tubes that touch the blood are sterile (free from germs) and are only used once.

An apheresis nurse will stay at the bedside to monitor for any reactions or problems.

Because your child will have tubes attached to the apheresis machine, they will not be able to leave the room once the procedure has started. Portable toilet equipment will be provided if needed.

In addition to the leukapheresis procedure, your child might need other tests or procedures. These might include:

• Lab tests: Blood tests may be performed to check your child’s blood cell counts. If your child’s blood counts are low, a blood transfusion might be needed before leukapheresis begins.
• Blood prime: If your child has a low red blood cell count or is smaller in size, staff might need to add donated blood to the apheresis machine’s tubing before starting the procedure. This helps make sure that your child’s red blood cell count does not become too low during leukapheresis.
• Replacement fluids and blood cells: Leukapheresis removes part of your child’s blood. In some cases, staff might need to add fluid or cells to the blood that is being returned. Your care team will let you know if this is needed and what to expect.

Possible side effects of leukapheresis

The side effects of leukapheresis are like those that can happen when people donate whole blood. Any side effects are usually mild and temporary. There is always the risk of rare or unknown side effects.

Side effects of leukapheresis may include:

• Nausea
• Dizziness
• Fainting
• Pain or bruising at the site where the needle is placed
• Blood loss
• Infection
• A lower blood cell count after the procedure. This decrease is usually small. But a blood transfusion or other therapy may be necessary.
• A reaction to the blood products received during leukapheresis. Although not common, this may require that the care team stop the procedure.
• If leukapheresis is stopped before it is complete, a small amount of the blood may not be returned to the body.

Side effects caused by blood-thinning medicine

During leukapheresis, your provider may give your child a medicine called citrate. This is a blood-thinning medicine. It keeps the blood from clotting in the apheresis machine. Citrate may cause side effects that include:

• Muscle cramping
• Numbness
• Chills
• Tingling sensations
• Strange or metallic taste in the mouth
• Feeling anxious
• Seizures (in rare cases)
  

The care team may give your child calcium, either by mouth or by vein, to prevent or treat these reactions.

When to contact your care team

Tell a member of your care team right away if your child has any of these symptoms during leukapheresis:

• Unusual sensations
• Discomfort
• Other side effects

If you have questions about your child’s leukapheresis procedure, talk to your care team.