AM25-MN-30-L - Interactive Panel and Audience Discussion: Navigating Clinical, Professional, and Ethical ‘Sticky Wickets’ in Leukapheresis for Hyperleukocytosis

Monday, October 27, 2025

5:00 PM - 6:00 PM PT

Room: SDCC 31

CE: 1 CME (AMA Physician Credit) / 1 CE (Non-Physician Credit)

Program Chair(s)

JC

Jensyn Cone Sullivan, MD

Director, Cellular Therapies Laboratory
Michigan Medicine at the University of Michigan
Ann Arbor, Michigan

Disclosure(s): No financial relationships to disclose

Handouts

Speaker(s)

Kyle Annen, DO

Medical Director of Apheresis and Cellular Therapy
Children's Hospital Colorado
Aurora, Colorado

Disclosure(s): No financial relationships to disclose
Laura Connelly-Smith, MBBCh,DM

Medical Director, Apheresis and Cellular Therapy and Professor of Hematology and Oncology
Fred Hutchinson cancer Research Center ? University of washington Medical Center
Seattle, Washington

Disclosure information not submitted.

Panelist(s)

MB

Mary Berg

University of Colorado
Aurora, Colorado

Disclosure information not submitted.
Suzanne Thibodeaux, MD, PhD (she/her/hers)

Washington University School of Medicine Department of Pathology and Immunology
St. Louis, Missouri

Disclosure information not submitted.
DL

Divjot Singh Lamba, M.D. Transfusion Medicine (he/him/his)

Dept of Transfusion Medicine, Post Graduate Institute of Education and Research (PGIMER) Chandigarh India
SAS NAGAR, Punjab

Disclosure information not submitted.
JJ

Jennifer Jones, MD

Division of Transfusion Medicine, Department of Pathology, University of Pittsburgh Medical Center and Vitalant, Pittsburgh, Pennsylvania, Pennsylvania

Disclosure information not submitted.

Hyperleukocytosis may provoke morbidity and mortality due to leukostasis, disseminated intravascular coagulation, and tumor lysis syndrome. The utility, efficacy, and safety of therapeutic leukocyte apheresis (TA) for hyperleukocytosis are debated. Recent studies have not demonstrated a concrete mortality benefit with the addition of TA to medical management. The ASFA guidelines recently downgraded TA for symptomatic hyperleukocytosis from Category II to III, "optimal role of TA not established," recommending individualized, patient-centered decision-making. TA for asymptomatic hyperleukocytosis remains a Category III.

TA for hyperleukocytosis is a common indication for urgent apheresis consults. Here, the AABB’s Therapeutic Apheresis Subsection sponsors a panel discussion of this impactful topic. Laura Connelly-Smith, first author of the ASFA guidelines, will introduce the data underlying the changes in ASFA guidelines (15 minutes). Then, she will join a moderated panel representing diverse opinions, specialty backgrounds, and career stages to discuss ~8 questions posed by Subsection members. Questions will focus on clinical, professional, and ethical ‘sticky wickets’ inherent in TA for hyperleukocytosis consults. Real-time audience polling will gauge attendees’ perceived viewpoint shifts over the course of the discussion (30 minutes). Finally, the session will close with an opportunity for open question and answer (10 minutes).

This session seeks to empower apheresis clinicians, trainees, and nurses to weigh the risks and benefits of TA in hyperleukocytosis. The main goal of the session is to support up-to-date, evidence-based, outcomes-focused care.

Learning Objectives:

Discuss the evidence underlying use of TA for hyperleukocytosis
Develop an approach to navigating clinical, professional, and ethical challenges inherent in TA for hyperleukocytosis consults
Gauge attendees’ perceived viewpoint shifts over the course of the discussion