Early Complications of Hyperleukocytosis and Leukapheresis in Childhood Acute Leukemias

Journal of Pediatric Hematology/oncology
Oussama AblaAhmed Naqvi

Abstract

Hyperleukocytosis in children with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) is associated with early morbidity and mortality. The benefit from leukapheresis is controversial, and its complications are not well defined. We analyzed the frequency of early complications in children with ALL and AML presenting with white blood cell (WBC) count >100×10/L, and the type and frequency of complications related to leukapheresis. During a 12-year period, 84 of 634 (13%) ALL and 18 of 143 (12.5%) AML patients presented with hyperleukocytosis. Leukapheresis was performed in 18 ALL and 12 AML patients. The median initial WBC was 474×10/L in the leukapheresis group compared with 175×10/L in the nonleukapheresis group. Neurological leukostasis occurred in 6 ALL (7.1%) and 4 AML (22.2%) patients. Pulmonary leukostasis occurred in 16 ALL (19%) and 4 AML patients (22.2%). Neurological symptoms improved in few patients after leukapheresis, except in patients with very high WBC (>650×10/L in ALL and >400×10/L in AML). Leukapheresis improved respiratory symptoms in some patients but caused worsening symptoms in others. Early death was associated with neurological complications, AML diagnosis, and coagulopathy. Leukapheresi...Continue Reading

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Citations

May 11, 2016·Journal of Pediatric Hematology/oncology·Sherif M Badawy
Oct 26, 2018·Frontiers in Pediatrics·Guillaume MaitreVivianne Amiet

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Methods Mentioned

BETA
leukapheresis

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