What is Leukapheresis? Let's learn about this treatment in simple terms.

When your doctor tells you or someone you know has a blood cancer like leukemia, they talk about each treatment method, right? You may have heard the word 'leukapheresis'. Although this name may sound a bit scary and complicated, it's not really that scary. Today, let's talk about what Leukapheresis is, why it's done, and how it works in a very simple way.

Simply put, what is leukapheresis?

Think of it like when we make coconut milk, we squeeze the coconut and separate the milk and the pulp. Leukapheresis is something like that. This involves taking some blood from your body, sending it through a special machine, which separates out the white blood cells . Then the rest of the blood, which is the red blood cells, plasma, and platelets, is put back into your body.

Why is this treatment necessary?

There are several reasons why doctors recommend this treatment. Let's look at the main reasons.

• When the number of white blood cells in the blood is very high: In some types of leukemia (for example, `(Acute Myeloid Leukemia - AML)`, `(Acute Lymphocytic Leukemia - ALL)`, `(Chronic Lymphocytic Leukemia - CLL)`) abnormal white blood cells increase uncontrollably. These cells can lodge in the blood vessels and obstruct blood flow. This increases the risk of damage to organs such as the heart and brain. So this treatment is used to quickly remove those extra cells and provide relief to the patient.
• Collect stem cells: For some types of cancer (for example, lymphoma, multiple myeloma), high-dose chemotherapy damages the bone marrow. So, before the treatment, healthy stem cells are collected from the blood and stored, and after the treatment, they are given back to the body. Then, new healthy blood cells can be made. These stem cells are collected through the leukapheresis method.
• To donate stem cells to someone else: If you are a suitable donor for a bone marrow transplant for another patient, this method is also used to obtain stem cells from you.
• To obtain cells for specific treatments: For new cancer treatments like CAR T-cell therapy, the patient's own immune cells are taken, "trained" in a laboratory to fight cancer, and then returned to the body. These cells are removed from the body through a process called leukapheresis.

What happens before treatment?

Before starting this treatment, your doctor will perform several tests.

• Blood tests: They check the white blood cell count, as well as the red blood cell and platelet levels.
• Electrolyte tests: Check the levels of salts in the body, such as calcium and potassium.
• Kidney and liver function tests.
• Blood coagulation tests.

Since this treatment will take several hours, please wear comfortable clothing . It is also a good idea to bring a book to read or something to watch on your phone during the treatment.

What happens during treatment?

You will be placed on a comfortable bed, and a nurse or doctor will insert two cannulas (IV lines) into your arms, like saline, into your veins. One will slowly drain your blood from your body into the machine, and the other will return the cleaned blood back to your body. Sometimes, a single large tube (central line) will be inserted into a large vein in your neck or under your arm. This has both ways of taking blood and giving it back.

This entire process can usually take two or three hours .

During the treatment, you may feel a tingling sensation around your hands, feet, and lips. Don't worry. This is because your blood calcium levels are slightly low. If you feel this way, tell the nurse there, and they will add some calcium to the saline solution they give you. Then the sensation will go away.

What to expect after treatment?

After your treatment, the medical staff will monitor you for a while. They will check your blood pressure and pulse. They may also take another blood sample. Depending on the results of those tests, if your red blood cell or platelet levels are low, your doctor may recommend a blood transfusion .

Are there any side effects to this? Should I be worried?

As with any medical treatment, there are potential side effects. However, serious side effects are rare . The most important thing is that a doctor or nurse will be watching you throughout the treatment. So if there is a problem, they will intervene immediately.

Let's see what the main side effects are that can occur.

After going home and when you need to talk to the doctor

It is best to rest for a day or so after the treatment. If you are receiving this treatment, you may already be receiving treatment for cancer or a blood-related disease. Therefore, if you experience any of the following symptoms, inform your doctor immediately .

• If you have a fever (over 38 Celsius or 100.4 Fahrenheit), this could be a sign of an infection.
• If you have a central line inserted, the site becomes red, swollen, painful, or pus-like fluid is coming out .
• If your symptoms seem to be getting worse .

Don't ignore things like this. The sooner you report it, the easier it is to control any issues.