Therapeutic Leukapheresis in Acute Leukaemia with Hyperleukocytosis: A Series of Three Cases

Acute Myeloid Leukaemia (AML) is a haematological malignancy marked by uncontrolled proliferation of immature myeloid cells, impairing normal blood cell production. Hyperleukocytosis, defined as a leukocyte count >100,000/μL (4000-11,000 cells/μL), increases blood viscosity and causes leukocytes to clump, leading to reduced blood flow and stasis. This leukostasis can result in complications like end-organ damage, tumour lysis syndrome, and disseminated intravascular coagulation. Chemotherapy may exacerbate these issues by triggering tumour lysis syndrome and other severe complications. Therefore, therapeutic leukapheresis can be the treatment of choice in such situations. In this case series, we share our experience in managing three AML cases that presented with life-threatening symptoms. All three patients presented to our centre with signs and symptoms of leukostasis, with hyperleukocytosis evident in their complete blood cell counts. If left untreated, these cases could have led to severe complications and even death. After evaluating the clinical and laboratory parameters, therapeutic leukapheresis was initiated to reduce leukocyte counts, leading to significant improvement in the patient’s condition. This case series emphasises the critical role of leukapheresis as a potentially life-saving intervention.