# Successful Therapeutic Leukapheresis for Chronic Myeloid Leukemia Identified by Persistent Erection: A Case Report

## TL;DR

A man with chronic myeloid leukemia had a persistent erection caused by high white blood cell count, which was successfully treated with leukapheresis.

## Contribution

This case report presents a novel use of leukapheresis to treat CML-induced priapism with rapid leukocyte reduction.

## Key findings

- Leukapheresis using the Spectra Optia® system effectively reduced leukostasis in a CML patient.
- Persistent erection resolved after two days of leukapheresis combined with hydroxyurea and febuxostat.
- Emergency penile incision and drug therapy were used alongside leukapheresis for successful treatment.

## Abstract

Cytoreduction in leukostasis can be achieved using leukapheresis. We report a case of chronic myeloid leukemia (CML) identified by a persistent erection, which was successfully treated using the Spectra Optia®︎ apheresis system. A 29-year-old male presented with an erection for 12 hours without identified triggers and no improvement despite penile corpus cavernosum puncture. His white blood cell count was 458,930/μL. A diagnosis of CML-induced persistent erection with secondary hyperleukocytosis was established. Following an emergency bilateral penile corpus cavernosum incision (distal shunting), he received hydroxyurea and febuxostat. Persistent erection resolved after leukapheresis for two consecutive days. Rapid leukocyte count reduction can effectively address leukostasis in CML without major complications.