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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/04/27 05:17:32」(JST)

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Leukapheresis is a laboratory procedure in which white blood cells are separated from a sample of blood. It is a specific type of apheresis, the more general term for separating out one particular constituent of blood and returning the remainder to the circulation.

Leukapheresis may be performed to decrease a very high white blood cell count, to obtain autologous (i.e., the patient's own) blood cells for later transplant back into the patient, or to obtain cells for research purposes. In the case of hematological malignancies such as acute leukemias, white blood cell counts may be high enough to cause hemostasis and "sludging" in the capillaries. This can affect retinal vasculature leading to vision changes, pulmonary vasculature leading to shortness of breath from decreased efficiency in oxygen exchange, as well as other organ systems such as the brain which would become clinically apparent with neurological deterioration of a patient from cerebrovascular compromise.

Leukapheresis may also be performed to obtain the patient's own blood cells for later transplant. White blood cells may be removed to protect them from damage before high-dose chemotherapy, then transfused back into the patient, in the treatment of advanced breast cancer.^[1] Another novel use of cells obtained through leukapheresis is to stimulate a patient’s immune system to target prostate cancer cells.^[2]

Alternatively, only granulocytes, macrophages and monocytes can be removed, leaving the lymphocyte count largely unchanged. This is used as a treatment for autoimmune diseases such as ulcerative colitis ^[3] and rheumatoid arthritis,^[4] where these cells play an active part in the inflammation process.

Leukapheresis, typically for granulocytes, is a rarely performed blood donation process. The product is collected by automated apheresis and is used for systemic infections in patients with neutropenia. The donor is typically a blood relative who has received stimulating medications (a directed donation), and the product is irradiated to prevent GVHD. The product generally has a 24-hour shelf life from collection and is often transfused before infectious disease testing is completed. It is a therapy of last resort, and its use is controversial and rare.

References

^ Transfusion. 2003 Feb;43(2):259-64. Leukapheresis after high-dose chemotherapy and autologous peripheral blood progenitor cell transplantation: a novel approach to harvest a second autograft. Schwella N, Braun A, Ahrens N, Rick O, Salama A.
^ Sipuleucel-T Immunotherapy for Castration-Resistant Prostate Cancer July 29, 2010Kantoff P.W., Higano C.S., Shore N.D., et al.N Engl J Med 2010; 363:411 - 422
^ * National Institute for Health and Clinical Excellence, Leukapheresis for inflammatory bowel disease (guidance). Retrieved Oct. 06 2005
^ | author = G Hahn, B Stuhlmüller, N Hain, J R Kalden, K Pfizenmaier, and G R Burmester | year = 1993 | pmc=288038 | title = Modulation of monocyte activation in patients with rheumatoid arthritis by leukapheresis therapy | journal = The Journal of Clinical Investigation | volume = 91 | pages = 862–70 | doi = 10.1172/JCI116307 | pmid = 8450066 | issue = 3

External links

Circular of Information for Blood Products

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1. 血液悪性腫瘍における白血球増多症および白血球症 hyperleukocytosis and leukostasis in hematologic malignancies
2. 癌免疫療法の原則 principles of cancer immunotherapy
3. 小児および思春期における急性リンパ芽球性白血病の治療の概要 overview of the treatment of acute lymphoblastic leukemia in children and adolescents
4. 去勢抵抗性前立腺癌に対する免疫療法 immunotherapy for castration resistant prostate cancer
5. 若年成人における急性骨髄性白血病に対する導入療法 induction therapy for acute myeloid leukemia in younger adults

English Journal

Successful continual intratympanic steroid injection therapy in a patient with refractory sensorineural hearing loss accompanied by relapsing polychondritis.

Wasano K1, Tomisato S2, Yamamoto S2, Suzuki N3, Kawasaki T2, Ogawa K3.
Auris, nasus, larynx.Auris Nasus Larynx.2017 Aug;44(4):489-492. doi: 10.1016/j.anl.2016.07.019. Epub 2016 Aug 20.
PMID 27552828

Hyperleucocytosis in paediatric acute myeloid leukaemia - the challenge of white blood cell counts above 200 × 109 /l. The NOPHO experience 1984-2014.

Zeller B1, Glosli H1, Forestier E2, Ha SY3, Jahnukainen K4, Jónsson ÓG5, Lausen B6, Palle J7, Hasle H8, Abrahamsson J9; NOPHO AML working group.
British journal of haematology.Br J Haematol.2017 May 25. doi: 10.1111/bjh.14692. [Epub ahead of print]
PMID 28542715

Clotting during autologous hematopoietic progenitor cells collection.

Gokhale A1,2, Quraishy N1, Veemara V3, Howdyshell H3, Murray L3, Royer J3, Salmi L3, Ricci K3, Liu H3.
Journal of clinical apheresis.J Clin Apher.2017 May 9. doi: 10.1002/jca.21539. [Epub ahead of print]
PMID 28485035

Japanese Journal

Heart rate variability during and after peripheral blood stem cell leukapheresis in autologous transplant patients and allogeneic transplant donors

NAKANE Takahiko,NAKAMAE Hirohisa,KOH Hideo,NAKAMAE Mika,AIMOTO Ran,TERADA Yoshiki,KOH Ki-Ryang,YAMANE Takahisa,HINO Masayuki
International journal of hematology 91(3), 478-484, 2010-04-15
NAID 10026401362

Safe And Efficient Collection of Cytokine-Mobilized Peripheral Blood Cells From Cynomolgus Monkeys (Macaca fascicularis) with Human Newborn-Equivalent Body Weights

AGEYAMA Naohide,HANAZONO Yutaka,SHIBATA Hiroaki,ONO Fumiko,OGAWA Hiromi,NAGASHIMA Takeyuki,UEDA Yasuji,YOSHIKAWA Yasuhiro,HASEGAWA Mamoru,OZAWA Keiya,TERAO Keiji
Experimental animals 54(5), 421-428, 2005-10-01
Hematopoietic stem cells in bone marrow can be mobilized into peripheral blood by cytokine administration. Cytokine-mobilized peripheral blood stem cells are of great use in clinical applications. We …
NAID 10016785510