Leukemoid Blood Pictures in Various Clincal Conditions

Krumbhaar, E. B.

doi:10.1097/00000441-192610000-00005

Cited by 74 publications

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“…5 Neutrophilia with leukocyte a count of Ն50 ϫ 10 3 /mm 3 associated with nonmalignant conditions has been described previously as leukemoid reaction (LR). 6 Earlier studies of LR were done in an adult population. Holland and Maurer 7 described the first case series of LR in a pediatric population, which included only 1 premature infant.…”

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Outcome of Extremely Low Birth Weight Infants With Leukemoid Reaction

Hsiao¹

2005

Pediatrics

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ABSTRACT. Background. Leukemoid reaction (LR) is defined as an absolute neutrophil count (ANC) of >30 ؋ 10 3 /mm 3 . No previous study has systemically examined the clinical and prognostic significance of this phenomenon in extremely low birth weight (ELBW) infants.Objective. The purpose of this study was to examine the effect of LR in morbidity, mortality, and long-term developmental outcome in ELBW infants.Method. Infants with gestational age of <30 weeks and birth weight <1000 g were included in the study (n ‫؍‬ 152). The medical records were reviewed for the clinical characteristics and long-term developmental outcome of these infants. Serial complete blood cell count and ANC were calculated on day 1 and weekly thereafter until discharge. LR was defined as an ANC of >30 ؋ 10 3 /mm 3 .Results. LR was detected in 17% of the study infants (26 of 152). ANC increased postnatally in LR (n ‫؍‬ 26) and no-LR (n ‫؍‬ 126) infants during hospitalization, peaked in the second week of life (43 ؎ 3 vs 14 ؎ 1 ؋ 10 3 /mm 3 ), and remained significantly higher in LR infants during the first 5 weeks of life. LR occurred more frequently during the first 2 weeks of life and lasted for 3 ؎ 1 days. There was no significant difference between the LR and no-LR infants in gestational age, birth weight, delivery mode, gender, Apgar scores, or incidence of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, and retinopathy of prematurity. LR infants required a significantly longer duration of ventilatory support (36 ؎ 4 vs 21 ؎ 2 days), longer duration of oxygen requirement (58 ؎ 6 vs 40 ؎ 3 days), and had a higher incidence of bronchopulmonary dysplasia (BPD) (54% vs 25%) compared with no-LR infants. Furthermore, the length of hospitalization was significantly longer in LR infants (69 ؎ 6 vs 54 ؎ 3 days). There was no significant difference between the groups in developmental outcome at 2 years of age including receptive/expressive language, fine/gross motor skills, and hearing. Incidence of abnormal neurodevelopment outcome was also similar between LR and no-LR infants.Conclusions. LR in ELBW infants is associated with a prolonged need for ventilatory and oxygen support, a higher incidence of BPD, and a tendency for lower mortality. The findings from our study suggest that LR is associated with conditions known to have an excess of proinflammatory cytokines. Additional prospective study is needed to understand the relationship between LR, proinflammatory cytokines, and development of BPD. Pediatrics 2005;116:e43-e51. URL: www.pediatrics.org/ cgi/doi/10.1542/peds.2004-1379; leukemoid reaction, absolute neutrophil count, extremely low birth weight infants, bronchopulmonary dysplasia.

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Outcome of Extremely Low Birth Weight Infants With Leukemoid Reaction

Hsiao¹

2005

Pediatrics

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“…The term, leukemoid reaction, first reported by Krumbhaar [1] in 1926, describes a group of nonmalignant adult and pediatric conditions with markedly elevated blood leukocyte counts. Neonatal leukemoid reactions have subsequently been described in patients with trisomy 21 [2], in preterm infants after antenatal and postnatal administration of steroids [3,4], and in patients in the neonatal intensive care unit (NICU) with a variety of clinical conditions [4].…”

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Neonatal Leukemoid Reaction and Early Development of Bronchopulmonary Dysplasia in a Very Low-Birth-Weight Infant

Zanardo¹,

Magarotto²,

Rosolen³

2001

Fetal Diagn Ther

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The factors controlling the recruitment of inflammatory cells and the activation of the cytokine cascade in low-birth-weight premature infants have been implicated in the sequence of multiorgan inflammatory diseases, including the chronic lung disease of prematurity, bronchopulmonary dysplasia. This article describes a 982-gram, 25 (+2 days) weeks’ gestation male infant, who had a leukemoid reaction throughout the first week of life, followed by early development of bronchopulmonary dysplasia.

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“…6 Historically leukemoid reactions have been defined as a leukocyte count >50 Â 10 9 l À1 with no evidence of malignancy. 7 A more recent definition is an absolute neutrophil count (ANC)>10 s.d.s above the mean for gestational age (that is, ANC>30 000 in the first 60 h of life or ANC>15 000 from 60 h to 28 days of life). 8 Hyperleukocytosis is often defined as total leukocyte count >100 Â 10 9 l À1 .…”

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confidence: 99%