Leukostasis in Chronic Lymphocytic Leukemia

Singh, Navdeep; Lubana, Sandeep Singh; Dabrowski, Lech; Sidhu, Gurinder

doi:10.12659/ajcr.924798

Cited by 10 publications

(8 citation statements)

References 18 publications

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“… 10 Leukapheresis can reduce the number of blast cells faster but the procedure is associated with the risk of blast cells’ rebound because the removal of blast cells is not accompanied by destruction of blast cells in the bone marrow which can quickly replace the removed blast cells in peripheral circulation. 11 , 12 Other disadvantages of leukapheresis procedure are the expensive cost, the requirement of the availability of special facilities, insertion of central venous catheter, and the need for experienced staff. 2 , 13 The main advantage of leukapheresis is being able to overcome metabolic disorders and coagulation via plasma and electrolyte administration during the procedure.…”

Section: Introductionmentioning

confidence: 99%

Leukapheresis Does Not Improve Early Survival Outcome of Acute Myeloid Leukemia with Leukostasis Patients – A Dual-Center Retrospective Cohort Study

Rinaldi¹,

Sari²,

Tedhy³

et al. 2021

JBM

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Introduction:Leukostasis is a medical emergency with high mortality which often occurs in acute myeloid leukemia patients with hyperleukocytosis. One of the therapies that can be used for leukostasis in acute myeloid leukemia is leukapheresis. However, whether leukapheresis can provide better survival benefit when compared with patients not receiving leukapheresis is still unclear. Hence, we aimed to evaluate the effect of chemotherapy plus leukapheresis combination versus chemotherapy only on 28-day survival of acute myeloid leukemia patients with leukostasis. Methods: This study was a dual-center retrospective cohort using secondary data from medical records collected from November 2018 to March 2019. Inclusion criteria were adult patients aged 18 years old or above, diagnosed with acute leukemia with hyperleukocytosis status defined by WBC count greater than 100,000/uL, and with symptoms of leukostasis. One-month survival analysis was conducted using Kaplan-Meier curve method. Univariate and multivariate analyses were then conducted using Cox proportional hazards model to obtain value of hazard ratio (HR) with a 95% confidence interval (CI). Results: A total of 38 patients were obtained for analysis. The median overall survival was 25 days (95% CI: 17.001-32.999 days) in the chemotherapy only group and 20 days (95% CI: 1.497-38.503) in the chemotherapy with leukapheresis group. The use of leukapheresis did not affect 28-day survival (HR: 1.140; 95% CI: 0.396-3.283; p value: 0.809) and 7-day survival (HR: 1.073; 95% CI: 0.277-4.152; p value: 0.919). In the multivariate analysis, age ≥60 years, blast percentage ≥90%, creatinine ≥1.4 mg/dL, and presence of disseminated intravascular coagulation were associated with worse 28-day survival. Conclusion: AML patients with leukostasis who received both chemotherapy and leukapheresis did not have better 28-day survival and 7-day survival when compared with patients receiving chemotherapy only. Old age, high blast percentage, high creatinine, and presence of disseminated intravascular coagulation were prognostic factors for worse 28-day survival.

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Section: Introductionmentioning

confidence: 99%

Leukapheresis Does Not Improve Early Survival Outcome of Acute Myeloid Leukemia with Leukostasis Patients – A Dual-Center Retrospective Cohort Study

Rinaldi¹,

Sari²,

Tedhy³

et al. 2021

JBM

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“…This enables leukemic cell adhesion and leads to leukostasis. 25 In addition, the high oxygen consumption of those leukemic cells competes for this scarce resource in the microcirculation, worsening the local tissue hypoxia and ischemia and resulting in tissue infarction. Furthermore, this temporary stasis may induce irreparable inner ear neuronal and vascular damage.…”

Section: Discussionmentioning

confidence: 99%

“…5 Hyperleukocytosis is a condition in which the WBC count is ≥100 × 10 9 /L. 25 Patients with a WBC count higher than 300 × 10 9 /L and a spleen size larger than 10 cm are more likely to develop leukostasis complications. 7,19,20 A previous 368 study on leukostasis in children and adolescents with CML reported a significantly higher median WBC concentration in leukostasis cases than in non-leukostasis cases: 458.5 × 10 9 /L versus 151.8 × 10 9 /L, respectively.…”

Section: Discussionmentioning

confidence: 99%

Sensorineural Hearing Loss in Juvenile CML: A Rare Case Report in Surabaya, Indonesia

Syamsuddin¹,

Notopuro²

2022

IMCRJ

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Chronic myeloid leukemia (CML) is a type of myeloproliferative neoplasm (MPN) in which granulocytes are the primary proliferating cells. CML in pediatric patients (juvenile CML) is an uncommon MPN, representing 2–3% of children newly diagnosed with leukemia. Sensorineural hearing loss that progresses rapidly is an uncommon early sign of a hematological disorder in patients with CML. This article presents the case of a 10-year-old patient with complaints of bilateral hearing loss for 2 weeks. Pure-tone audiometry indicated sensorineural hearing loss of the left ear and mixed hearing loss of the right ear. After an in-depth evaluation of a bone marrow smear and positivity for the BCR-ABL fusion gene, it was concluded that the patient had chronic-phase juvenile CML. However, hearing loss recovery after hydroxyurea therapy could not be observed because the patient died after suffering an uncontrolled seizure on day 14 of hospitalization.

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“…3,5,7,8 CLL presents a potential confounding variable in this case; however, as we have reviewed earlier, the risk of leukostasis at WBC counts < 1000 × 10 9 /L is very low. 11 It is also probable that the patient had some level of immune dysregulation secondary to CLL, leading to his prolonged course and slow clearance of the virus.…”

Section: Discussionmentioning

confidence: 99%

“…10 While it is not uncommon to see hyperleukocytosis (total WBC count > 100 × 10 9 /L) in CLL, leukostasis is rare with most reports demonstrating WBC counts > 1000 × 10 9 /L. 11 Hematology, vascular surgery, and urology services were consulted and agreed that ischemic priapism was due to microthrombi or pelvic vein thrombosis secondary to COVID-19-associated coagulopathy (CAC) was the most likely etiology.…”

Section: Differential Diagnosismentioning

confidence: 99%

SARS-CoV-2: A Novel Precipitant of Ischemic Priapism

Mascarenhas¹

2022

Federal Practitioner

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Leukostasis in Chronic Lymphocytic Leukemia

Cited by 10 publications

References 18 publications

Leukapheresis Does Not Improve Early Survival Outcome of Acute Myeloid Leukemia with Leukostasis Patients – A Dual-Center Retrospective Cohort Study

Leukapheresis Does Not Improve Early Survival Outcome of Acute Myeloid Leukemia with Leukostasis Patients – A Dual-Center Retrospective Cohort Study

Sensorineural Hearing Loss in Juvenile CML: A Rare Case Report in Surabaya, Indonesia

SARS-CoV-2: A Novel Precipitant of Ischemic Priapism

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