White Cell Depletion
White blood cells, also known as leukocytes, are a part of our germ-fighting immune system. However, patients with leukemia, and those with other conditions leading to high white blood cell counts, may undergo leukocyte depletion to remove excess white cells before receiving chemotherapy.
Leukocyte depletion is a non-surgical procedure that requires insertion of either two small intravenous (IV) catheters or one larger central intravenous catheter to continually remove and return small amounts of blood. This blood travels through our bedside apheresis machine, which separates blood into its components: plasma, platelets, white cells, and red cells. White blood cells are collected into a bag and disposed of at the end of the procedure. The remaining components of the blood (plasma, platelets and red cells) are returned to the patient. One procedure can reduce the amount of white blood cells by 30 to 60 percent. Sometimes a second procedure is required to bring down to the targeted white blood cell count, to treat symptoms related to high white cell counts.
What to Expect
If intravenous catheters are placed, the arms will be propped on pillows and you will be asked to intermittently pump a fist to help promote blood flow. One may experience bruising or discomfort at the insertion sites. If a larger catheter is used, one will have free use of their arms during the procedure.
The procedure typically lasts 3 to 4 hours, but can last shorter or longer depending on a variety of factors. After starting the procedure, one may experience some mild numbness or tingling, especially of the fingertips or around the mouth. Rarer symptoms include lightheadedness and nausea. An apheresis staff member specialized with the procedure will be with you throughout the treatment and should be notified of any side effects to help alleviate the symptoms.