The Procedure Of Leukapheresis Is Used To Treat Chronic Lymphocytic Leukemia (CLL) And High Levels Of White Blood Cells

 

Leukapheresis 

Leukapheresis is a treatment for chronic lymphocytic leukemia (CLL) and patients with extremely high white blood cell counts. During Leukapheresis, your blood is processed by a machine that removes white blood cells while returning all other blood cells and plasma to the bloodstream. The goal of Leukapheresis is to reduce the number of leukemiaPatient-specific cells as quickly as possible. To prevent the cell count from increasing over time, most patients require chemotherapy, monoclonal antibody treatment, or targeted therapy to kill the remaining cancer cells.

Your care team will insert two intravenous (IV) lines into your body during a Leukapheresis. One IV line will remove blood, while the other will return cleaned blood to the patient. The procedure takes between two and three hours to complete. Although Leukapheresis is not painful, some patients find it difficult to sit or lie in the same position for the duration of the procedure. The removed white blood cells are collected and sent to a laboratory for processing. After they are finished, the cells will be returned to your doctor to be transfused back into your body.

In the following cases, Leukapheresis may be an option for treatment:

·        The patient has an extremely high white blood cell count.

·        A doctor requires a patient's blood cells for later transplantation back into the patient.

·        Obtaining cells for research

Leukapheresis is the separation and collection of white blood cells. It is the first step in a treatment known as CAR T-cell therapy (chimeric antigen receptor). When a person's cancer returns, CAR-T therapy may be offered to them. T-cells are collected and used to create CARs, a special type of T-cell. Researchers want to collect these cells from people who might be eligible for a future CAR T-cell study.

Patient specific elements (e.g., presence of NK-cells/circulating leukemic blasts and/or inhibitory myeloid derived suppressor cells) along with other parameters of the apheresis product itself appear to influence efficacy and toxicity profiles of adoptive cell therapy.

Leukapheresis is a required step in the development of "CAR therapy" or other adoptive cellular therapy products. Several clinical trials involving CAR therapy are currently underway at the NCI. The goal of this protocol is to create a streamlined process for patients to undergo apheresis in order to develop a CAR cell or other adoptive cell therapy product for a subsequent therapeutic clinical trial that can be administered when the patient requires investigational therapies. Emerging evidence suggests that elements of the apheresis product play a critical role in the outcomes of adoptive cell therapy. Methodologies for optimizing the timing and composition of apheresis collection are critical to manufacturing feasibility and remain an active area of research.