Leukostasis is a relatively uncommon but potentially catastrophic complication of
acute myelogenous leukemia (AML). Prompt leukoreduction is considered imperative to reduce the high mortality rate in this condition. Leukapheresis, usually associated with
chemotherapy, is an established approach to diminish blast cell counts. We report a single center experience in managing
leukostasis with leukapheresis. Fifteen patients with
leukostasis of 187 patients with AML (8.02%) followed at our institution were treated with leukapheresis associated with
chemotherapy. The procedures were scheduled to be performed on a daily basis until clinical improvement was achieved and WBC counts were significantly reduced. Overall and early mortalities, defined as that occurred in the first 7 days from diagnosis, were reported. A high proportion of our patients with
leukostasis (46.66%) had a monocytic subtype AML (M4/M5, according to French-American-British classification). The median overall survival was 10 days, despite a significant WBC reduction after the first
apheresis procedure (from 200.7 × 10⁹/L to 150.3 × 10⁹/L). Almost half of patients (7/15) had an early death. Therapeutic leukapheresis, associated or not to
chemotherapy, is an effective approach to reduce WBC counts in patients with AML and
leukostasis; however, this therapeutic procedure does not appear to change significantly the sombre prognosis observed in the majority of patients with this complication. Other forms of treatment must be found to reduce the high mortality rate related to
leukostasis.