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Severe hyperleukocytosis and multifocal intracranial haemorrhage: not always a fatal outcome

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Abstract

Severe hyperleukocytosis caused by acute lymphoblastic leukaemia (ALL) is associated with an increased risk of early death due to the intracranial haemorrhage. We report on a boy who presented with ALL with an extremely high leukocyte count, who developed neurological deterioration due to multiple intracerebral haemorrhages. Adequate measures for managing this medical emergency include appropriate supportive measures and initiation of therapy to prevent symptoms of leukostasis. Aggressive measures as a decompressive craniectomy should be considered to improve the poor outcome observed in this subset of patients.

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References

  1. Eguiguren JM, Schell MJ, Crist WM, Kunkel K, Rivera GK. Complications and outcome in childhood acute lymphoblastic leukemia with hyperleukocytosis. Blood. 1992;79:871–5.

    CAS  PubMed  Google Scholar 

  2. Lowe EJ, Pui CH, Hancock ML, Geiger TL, Khan RB, Sandlund JT. Early complications in children with acute lymphoblastic leukaemia presenting with hyperleukocytosis. Pediatr Blood Cancer. 2005;45:10–5. doi:10.1002/pbc.20178.

    Article  PubMed  Google Scholar 

  3. Bunin NJ, Pui CH. Differing complications of hyperleukocytosis in children with acute lymphoblastic or acute nonlymphoblastic leukaemia. J Clin Oncol. 1985;3:1590–5.

    Article  CAS  PubMed  Google Scholar 

  4. Fritz RD, Forkner CE, Freireich EJ, et al. The association of fatal intracranial hemorrhage and “blastic crisis” in patients with acute leukaemia. N Engl J Med. 1959;261:59–64.

    Article  CAS  PubMed  Google Scholar 

  5. Wurthner JU, Kohler G, Behringer D, Lindemann A, Mertelsmann R, Lubbert M. Leukostasis followed by hemorrhage complicating the initiation of chemotherapy in patients with myeloid leukaemia and hyperleukocytosis. Cancer. 1999;85:368–74. doi:10.1002/(SICI)1097-0142(19990115)85:2<368::AID-CNCR14>3.0.CO;2-X.

    Article  CAS  PubMed  Google Scholar 

  6. Lichtman MA, Rowe JM. Hyperleukocyotis leukemias: rheological, clinical, and therapeutic considerations. Blood. 1982;60:279–83.

    CAS  PubMed  Google Scholar 

  7. Lane TA. Continuous-flow leukapheresis for rapid cytoreduction in leukaemia. Transfusion. 1980;20:455–7. doi:10.1046/j.1537-2995.1980.20480260280.x.

    Article  CAS  PubMed  Google Scholar 

  8. Porcu P, Farag S, Marcucci G, Cataland SR, Kennedy MS, Bissell M. Leukocytoreduction for acute leukaemia. Ther Apher. 2002;6:15–23. doi:10.1046/j.1526-0968.2002.00402.x.

    Article  PubMed  Google Scholar 

  9. Wiernik PH, Serpick AA. Factors effecting remission and survival in adult acute nonlymphoblastic leukaemia. Medicine (Baltimore). 1970;49:505–13. doi:10.1097/00005792-197011000-00004.

    Article  CAS  Google Scholar 

  10. Gilchrist GS, Fountain KS, Dearth JC, Smithson WA, Burgert EO. Cranial irradiation in the management of extreme leukemic leukocytosis complicating childhood acute lymphocytic leukaemia. J Pediatr. 1981;98:257–9. doi:10.1016/S0022-3476(81)80653-1.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Paediatric Oncology, Catholic University of Rome, Largo A. Gemelli 8, 00168, Rome, Italy

    Antonio Ruggiero, G. Attinà, P. Maurizi, S. Mastrangelo & R. Riccardi

  2. Pediatric Intensive Care Unit, Catholic University of Rome, Rome, Italy

    M. Piastra & D. Pietrini

Authors
  1. Antonio Ruggiero
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  2. G. Attinà
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  3. M. Piastra
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  4. P. Maurizi
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  5. S. Mastrangelo
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  6. D. Pietrini
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  7. R. Riccardi
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Corresponding author

Correspondence to Antonio Ruggiero.

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Ruggiero, A., Attinà, G., Piastra, M. et al. Severe hyperleukocytosis and multifocal intracranial haemorrhage: not always a fatal outcome. Int J Hematol 90, 87–90 (2009). https://doi.org/10.1007/s12185-009-0333-2

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  • DOI: https://doi.org/10.1007/s12185-009-0333-2

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