Therapeutic cytoreduction in a 7‐month‐old baby with acute leukemia

A 7‐month‐old girl with acute biphenotypic leukemia [t(4;11)] had accompanying anemia, thrombocytopenia, and a white blood cell count of 535,000/μL with 98% blasts. Before instituting chemotherapy, therapeutic leukapheresis was done to reduce the threat of complications from leukostasis. Using a Cobe Spectra blood cell separator primed with modified blood, we processed 1,395 mL of her blood, removing 201 mL of the buffy coat containing 5.8 × 10 10 white blood cells. This reduced the WBC count to 301,000/μL. Only a single procedure was done, without significant complications. The rationale of this preparatory cytoreduction is discussed critically. Subsequent chemotherapy resulted in a long‐lasting remission. © 1992 Wiley‐Liss, Inc.