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Info


A. Characteristicsnavigator

  1. Elevation of White blood count (WBC) > 100K/µL (hyperleukocytosis)
  2. Symptoms of vascular interruption
    1. Stroke
    2. Renal Failure
    3. Myocardial Infarction
    4. Skin Disease - purpura, others
    5. Pulmonary Failure
  3. This is a medical emergency

B. Occurrencenavigator

  1. AML
  2. CML with blast crisis
  3. ALL
  4. Uncommon in CLL (very small cells)

C. Treatmentnavigator

  1. Intravenous Hydration
  2. Allopurinol
    1. Reduces uric acid production
    2. Great deal of uric acid released with spontaneous or drug induced tumor cell lysis
  3. Hydroxyurea - rapid kill of tumor cells
  4. Cranial Irradiation - may prevent strokes; efficacy still controversial
  5. Specific therapy for underlying disease
    1. AML: Daunorubicin + Ara C then High Dose AraC (HiDAc)
    2. ALL: glucocorticoids, alkylating agents, CNS therapy
  6. Leukopheresis is marginally effective, used in life-threatening situations
    1. Central nervous system symptoms
    2. Pulmonary failure

References navigator

  1. Baer MR. 1993. Hematol Oncol Clin North Am. 7(1):275 abstract
  2. Mauro MJ. 2003. NEJM. 349(8):767 abstract