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Dear colleagues,
I have been unable to obtain this article through my usual resources. Is anyone on the list able to provide me with it?

Expert Rev Hematol. 2017 Feb;10(2):147-154. doi: 10.1080/17474086.2017.1270754.

Epub 2016 Dec 26.



Hyperleukocytosis and leukostasis: management of a medical emergency.



Giammarco S(1), Chiusolo P(1), Piccirillo N(1), Di Giovanni A(1), Metafuni E(1),

Laurenti L(1), Sica S(1), Pagano L(1).



Author information:

(1)a Department of Hematology , Universita' Cattolica del Sacro Cuore , Rome ,

Italy.



INTRODUCTION: Hyperleukocytosis is defined as a white blood cell count greater

than 100,000/mL in patients affected by acute leukemia and often it is associated

with increased morbidity and mortality, that can be up to 40% if unrecognized.

Areas covered: Risk factors include younger age, myelomonocytic or

monocytic/monoblastic morphology, microgranular variant of acute promyelocitic

leukemia and T-cell ALL, and some cytogenetic abnormalities. Poor prognosis due

to high early death rate secondary to leukostasis. The mechanisms at the origin

of leukostasis are still poorly understood. The management of acute

hyperleukocytosis and leukostasis involves supportive measures and reducing the

number of circulating leukemic blast cells, with careful monitoring of fluid

balance, control of uric acid production and control of urine pH to prevent

tumour lysis syndrome. Expert commentary: Several studies have been performed to

ameliorate the outcome of this setting of patients. The high number of leukocytes

may cause 3 main complications: disseminated intravascular coagulation (DIC),

tumor lysis syndrome (TLS), and leukostasis. Although hyperleukocytosis and

tumour lysis syndrome are still a challenge for clinicians, a better prognosis

for these conditions is emerging in the last years.



DOI: 10.1080/17474086.2017.1270754

PMID: 27967252  [Indexed for MEDLINE]
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--SHAWN

Shawn Steidinger, MLS, AHIP
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