Leukostasis and hyperleukocytosis: Difference between revisions
| Line 32: | Line 32: | ||
== Treatment == | == Treatment == | ||
#IV hydration | |||
##Prevent dehydration which can worsen condition | |||
#Chemotherapy | |||
##Only treatment proven to improve survival | |||
#Hydroxyurea + leukapheresis | |||
##Can be use for cytoreduction if chemo will be delayed | |||
== Disposition == | == Disposition == | ||
Revision as of 03:15, 23 October 2011
Background
- Pathologic diagnosis where WBC plugs seen in microvasculature
- High blast cell counts, blood viscosity is increased
- Blood flow is slowed by aggregates of tumor cells, and the primitive leukemic cells are capable of invading through endothelium and causing hemorrhage
- Usually seen in pts with AML, not seen in CML or CLL
- WBC count usu >100k, can happen as low as 50K
- Brain and lung are most commonly affected
Clinical Features
- Brain Leukostasis
- headache
- stupor
- dizziness
- tinnitus
- visual disturbances
- ataxia
- confusion
- coma
- sudden death
- Pulmonary Leukostasis
- respiratory distress
- hypoxemia
- respiratory failure
Diagnosis
- High degree of suspicion to make diagnosis
- WBC count usu >100k, can happen as low as 50K + symptoms from tissue hypoxia
- CXR usu show interstial or alveolar infiltrates
Treatment
- IV hydration
- Prevent dehydration which can worsen condition
- Chemotherapy
- Only treatment proven to improve survival
- Hydroxyurea + leukapheresis
- Can be use for cytoreduction if chemo will be delayed
Disposition
- Admit to ICU
Source
Harrison's Internal Medicine Oncologic Emergencies & Uptodate