Hyperleukocytosis and leukostasis in acute and chronic leukemias

Early mortality in acute myeloid leukemia with KMT2A rearrangement is associated with high risk of bleeding and disseminated intravascular coagulation

“…AML remains unclear, one clue can be discerned by noting the loss of significant difference of monocytic phenotype between the KMT2Ar induction should be considered, given some evidence this intervention reduces all-cause mortality in this setting. 26,27 Finally, our findings support routine imaging to assess extramedullary disease before treatment start to better estimate burden of disease in KMT2Ar AML and subsequent response to therapy.…”

“…Our findings support monitoring of coagulation and DIC parameters during KMT2Ar AML treatment similar to what is done in APL, including correction with cryoprecipitate when fibrinogen levels are low, transfusing to maintain a higher platelet count, in addition to early recognition and aggressive management of DIC, particularly regarding pulmonary complications as important considerations that could mitigate the risk of death during induction treatment in KMT2Ar AML. Given the propensity for hyperleukocytosis and DAH with KMT2Ar , implementation of high‐dose corticosteroids during induction should be considered, given some evidence this intervention reduces all‐cause mortality in this setting 26,27 . Finally, our findings support routine imaging to assess extramedullary disease before treatment start to better estimate burden of disease in KMT2Ar AML and subsequent response to therapy.…”

Ausgewählte hämato-onkologische Notfälle

“…Die untere Konzentration der Zellzahl liegt je nach der Publikation bei mindestens 50 000/μl bzw. oberhalb von 100 000/μl [7]. maßen.…”

Effectiveness of leukapheresis on early survival in acute myeloid leukemia: An observational propensity score matching cohort study

“…[1][2][3] The definition of HL varies among leukemia subtypes based on the diameter or size of white blood cells (WBCs) or leukemic cells. [4][5][6] For acute promyelocytic leukemia (APL), AML, and acute lymphoblastic or chronic lymphocytic leukemia, WBC counts of 50 Â 10 9 /L, 100 Â 10 9 /L, and 200 Â 10 9 /L or greater, respectively, are regarded as HL. 2,4 Rapid reduction of the leukemic cell mass could be achieved through leukapheresis (LK), bridging chemotherapy, or administration of hydroxyurea or glucocorticosteroids to alleviate leukostasis symptoms and enhance 30-d survival rates.…”

“…Hyperleukocytosis (HL) occurs in approximately 10% to 20% of acute myeloid leukemia (AML) cases and can lead to critical symptoms in patients with leukemia 1‐3 . The definition of HL varies among leukemia subtypes based on the diameter or size of white blood cells (WBCs) or leukemic cells 4‐6 . For acute promyelocytic leukemia (APL), AML, and acute lymphoblastic or chronic lymphocytic leukemia, WBC counts of 50 × 10 9 /L, 100 × 10 9 /L, and 200 × 10 9 /L or greater, respectively, are regarded as HL 2,4 …”