Therapeutic Leukapheresis in a Pediatric Acute Myeloid Leukemia (AML) Crisis as a Critical Life-Saving Adjunctive Therapy: A Case Report

TL;DR

Therapeutic leukapheresis helped save a child's life during a severe AML crisis by rapidly lowering dangerous white blood cell levels.

Contribution

Demonstrates the life-saving effectiveness of leukapheresis as an adjunctive therapy in pediatric AML crises.

Findings

Leukapheresis reduced the patient's leukocyte count by 81% without adverse events.

The patient showed symptomatic improvement and stabilization after the procedure.

Leukapheresis prevented life-threatening complications from hyperleukocytosis.

Abstract

Hematological malignancies can present with severe complications, including hyperleukocytosis, which demands immediate intervention due to elevated leukocyte counts that increase blood viscosity and cause microcirculatory abnormalities. This case report highlights the critical role of therapeutic leukapheresis in managing a pediatric patient with acute myeloid leukemia (AML) in crisis. A six-year-old male child presented with symptoms of severe hyperleukocytosis, including high-grade fever, respiratory distress, and a significant leukocyte count (555,820/µL). Immediate interventions included intravenous hydration, antibiotics, steroids, and non-invasive ventilation, followed by therapeutic leukapheresis. The leukapheresis procedure successfully reduced the leukocyte count by 81% without any adverse events. Post-procedure treatment with etoposide further decreased the leukocyte count, leading to symptomatic improvement and stabilization of the patient. The patient was later discharged in stable condition and continued receiving induction-phase chemotherapy. This case underscores the efficacy and necessity of leukapheresis as a life-saving adjunctive therapy in pediatric AML crises, demonstrating its role in rapidly reducing leukocyte counts and preventing life-threatening complications.

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