Therapeutic leukapheresis in a patient with prolymphocytic transformation of B-cell chronic lymphocytic leukemia.

A 64-year old woman with chronic lymphocytic leukemia (CLL) developed a prolymphocytic transformation with severe anemia, thrombocytopenia and deterioration of the general clinical condition. Neither treatment with chlorambucil and prednisolone, nor a combination chemotherapy (cyclophosphamide, vincristine, prednisolone) were successful. Splenectomy was not considered as the bone marrow presented signs of dyserythropoiesis. Encouraged by the results of therapeutic leukapheresis in different forms of leukemia, it was decided to start such therapy in our patient. During a seven-month period, thirty weekly aphereses were performed. The white blood cell count did not decrease, but the clinical condition of the patient improved dramatically.