Leukapheresis, Performed To Obtain the Patient's Own Blood Cells for Later Transplant, Has Potential in Cancer Treatment

 

Leukapheresis refers to a medical process involving the separation of white blood cells from a patient's plasma or blood. In most situations, this separation is achieved by "micronizing" the plasma. Essentially, this is done by subjecting it to an extreme temperature, which causes it to coagulate (turn coagulant) - this process is similar to that used in photothermolysis, where the very hot surfaces of photorefractive plates are exposed to high energy levels in order to produce a reaction with their substrate, creating a change in color. Leukapheresis also involves the use of chemicals; generally, "leukotriene modifiers" are the chemical that undergo this separation process and can range from the fairly benign to the potentially life threatening.

Several companies in the U.S. are focused on leukapheresis collections. For instance, in January 2019, Key Biologics LLC, a Cellero company based in the U.S., and Cascade Regional Blood Services announced a multi-year agreement to provide researchers in academia, pharma and biotech with vital blood products and materials, especially on collection of mononuclear cells by leukapheresis.


 

Sometimes, leukapheresis can be effective. If it removes leukemia cells, it has the potential to relieve pain, swelling, and other signs and symptoms of leukemia. Unfortunately, when leukapheresis removes cancer cells, it can also remove any residual beneficial antineoplastic activity that the patient's body might have already begun to undertake. This is known as antineoplastic chemotherapy and frequently produces undesirable side effects, such as excessive bleeding, bruising, nausea, vomiting, and diarrhea.

Furthermore, since leukapheresis utilizes blood monocytes to accomplish its separation process, it can also affect and kill healthy white blood cells as well. This is referred to as antithrombin syndrome and is very dangerous because it is the mechanism by which cancer cells are able to enter the blood stream. If leukapheresis kills healthy cells, it can cause severe and life-threatening anemia, kidney disease, and thrombosis - conditions that may even result in death.

There are a number of leukapheresis alternatives. One of the most common alternative procedures is called peripheral blood transplantation, or PBTV. With PBTV, a venous blood vessel is harvested from the arm and then the blood is drained into the bag, which is returned to the person's blood bank. This procedure is usually performed in a hospital setting, but may also be performed in a private laboratory or other healthcare center.

Another alternative procedure for leukapheresis involves procuring a blood bag from the person who will donate and later transplanting that bag into the person who will receive the Leukapheresis. This option involves collecting a single unit of blood from the person who will receive the Leukapheresis, and then harvesting a blood bag from the person who will donate that same unit. The blood bag is later transferred into the recipient and then upon collection of the bag is transferred back into the blood bank.

A blood carrier may also perform leukapheresis as a stand-alone procedure. However, there are some disadvantages to this approach. In addition to having a higher than average incidence of donation rejection, blood carrier leukapheresis can result in the same problems that occur with blood banks. A blood carrier who is capable of standing by and collecting a leukapheresis unit for a patient who has Leukopenia may have an increased risk of transferring the wrong type of Leukapheresis concentrate, resulting in a higher risk of the concentration of the wrong protein (such as a polymer that is too highly expressed in the patient's plasma) being collected.

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