Leukapheresis: Hyperleukocytosis

Labs before: iCa, hemoglobin/hematocrit, fibrinogen

Time: 2-4 hours

Prime: diluted blood if extracorporeal volume (ECV) is >10-15% total blood volume (TBV), albumin if borderline, otherwise NS

Anticoagulant: citrate (regional)

• Must run CaCl replacement throughout

• Check iCa at 15-30 minutes, then at least every hour, sooner if needing bolus

Maintain net ± 15% fluid balance

• Replacement fluid: albumin/FFP, blood products likely needed

• Calculated by nephrology

Follow CBC hourly, as Plt (and RBCs to lesser extent) can also be removed in the buffy coat

• Reduction of 30-60% of WBC count