Leukostasis
Leukostasis, also known as symptomatic hyperleukocytosis, is a medical emergency in patients with leukemia, particularly acute myeloid leukemia (AML) and in the blast phase of chronic myeloid leukemia (CML), characterized by the over-accumulation of leukemic cells within the small vessels. Although it potentially affects any organ, the lungs, and the brain are the most commonly involved, presenting with symptoms due to vascular occlusion.
Clinical presentation
It is most commonly seen as a complication of white blood cell counts over 100 x 10/L (100,000/microL).
It needs to be considered in any patient with myelogenous leukemia with an acute onset dyspnea and normal chest radiograph or pulmonary edema. Symptoms are due to obstruction of small pulmonary vessels or coronary artery(ies) by leukemic cells.
Radiographic features
Plain radiograph
Refer to subarticle - pulmonary leukostasis for more detail
- normal chest radiograph
- pulmonary edema
- usually, no evidence of interstitial infiltrates
Treatment and prognosis
Leukostasis is an emergency and commonly managed with leukapheresis to remove the excess of leukemic cells in circulation .
See also
