Application of exchange transfusion in the treatment of hyperleukocytosis:a retrospective analysis

Abstract Background Few reports have described the application of exchange transfusion in patients with hyperleukocytosis. Methods A retrospective clinical analysis of infants with exchange transfusion in the treatment of hyperleukocytosis was performed. Results A total of 13 patients were enrolled in the study.7 patients survived and 6 died after exchange transfusion.The incidence of pulmonary hypertension, heart failure, pertussis encephalopathy, Increased C-reactive protein, and increased PCT in the survival group were lower than those in the death group,The incidence of received Gamma globulin and received steroids were higher than those in the death group.The highest WBC count in the survival group was 74.15 ± 19.68*10^9/L, and in the death group patients was 86.29 ± 23.51*10^9/L.There were not significant differences two groups(P = 0.332). Decrease rate of WBC after the first ET in the survival group was significantly higher than that of the death group (P༜0.05). In the survival group, there were 5 patients (71.42%) which decrease rate of WBC after the first ET more than 50%, and the remaining 2 patients (28.58%) all exceeded 45%.In contrast, there was 1 patient which decrease rate of WBC exceeded 45% ,no patient exceed 50%. All patients with Decrease rate of WBC after the first ET exceed 50% survived. In the death group, there were 4 patients (66.67%) which N/L exceeded 1, 3patients (50%) which N/L exceeded 2. In the survival group, only 3 patients (42.85%) which N/L exceeded 1, but there was no patient which N/L exceed 2. Conclusion Exchange transfusion is an effective method to reduce WBC count. Patient with Decrease rate of WBC after the first ET exceed 50% were easier to survive. Patients with hyperleukocytoemia which N/L exceeding 2 predict death.