Pleural effusions in acute and chronic leukemia and myelodysplastic syndrome

Abstract

Pleural effusions may occur with acute and chronic leukemia and MDS. Infection remains the most common cause. Malignant pleural effusions tend to occur in advanced disease in chronic leukemia, but they can be seen at any time with acute leukemia and MDS. With standard precautions, pleural procedures may be performed safely in this population. In cases of unclear cause, pleural and bone marrow biopsy should be considered.

Non‐specific pleuritis in patients with active malignancy

“…Malignant pleural effusion confers a poor prognosis for patients with solid tumour or haematological malignancy as it signifies advanced disease. 1,2 However, patients with malignancy may also develop paramalignant effusions, which are usually due to treatment effect, pulmonary embolism, radiation therapy or chemotherapy. 3,4 Pleural inflammation underlies the formation of most exudative paramalignant effusions and is a common histological finding irrespective of the underlying aetiology.…”

Flow Cytometry and Effusions in Lymphoproliferative Processes and Other Hematologic Neoplasias

“…The presence of a pleural effusion in myelodysplastic syndromes (MDS) is rare and, as in other hemopoietic diseases, it is usually a consequence of infection [17,18,37]. Pleural effusion, secondary to leukemic infiltration, is a rare initial manifestation in patients with MDS.…”

“…For CLL/SLL in autopsy series, pleural involvement has ranged from 3 to 16% [17]. The appearance of malignant cells of this lymphoma type in body cavity effusions is common, and it is diagnosed mostly several years after the first diagnosis of the tumor [18,19].…”

Pleural effusions in hematologic malignancies and their management with indwelling pleural catheters

“…Treatment may require dose interruption or cessation, initiation of steroid or diuretic therapy, and pleural interventions. Radiation may be used in treatment of lymphoma and acute lymphocytic leukemia (ALL), and evaluation of the radiation field and/or pleural biopsy may help confirm the diagnosis (15).…”

“…ALL may present with a mediastinal mass and pleural or pericardial effusion. The pleura, central nervous system and testes are common sites of relapse (15). Pleural effusions in CLL typically occur in advanced disease or indicate a synchronous cancer, of which melanoma, sarcoma and lung cancer are the most frequent (18, 19).…”