Leukemic cell lysis pneumopathy
Leukemic cell lysis pneumopathy, also referred to as acute lysis pneumopathy, refers to an acute respiratory failure that can occur in patients with leukemia after the initiation of chemotherapy, particularly in those with hyperleukocytosis. On imaging, it manifests with features of acute respiratory distress syndrome (ARDS).
It is commonly seen in those patients with high leukocytes count, over leukocyte counts, 200,000/mL 2,4,
It presents an acute onset of respiratory failure usually seen within 48 hours from the start of chemotherapy 4. Associated fevers and hemoptysis have been described 4.
Treatment and complications
Life-supportive measures, with these patients usually admitted to ICU. Steroids, although controversial, are commonly used.
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- 2. Girish S. Shroff, Mylene T. Truong, Brett W. Carter, Marcelo F. Benveniste, Rashmi Kanagal-Shamanna, Greg Rauch, Chitra Viswanathan, Prajwal C. Boddu, Naval Daver, Carol C. Wu. Leukemic Involvement in the Thorax. (2019) RadioGraphics. 39 (1): 44-61. doi:10.1148/rg.2019180069 - Pubmed
- 3. Chest radiographic and CT findings in hyperleukocytic acute myeloid leukemia. (2016) Medicine. 95 (44): e5285. doi:10.1097/MD.0000000000005285 - Pubmed
- 4. Myeloid Leukemias and Lung Involvement. (2005) Seminars in Respiratory and Critical Care Medicine. 26 (05): 514. doi:10.1055/s-2005-922034 - Pubmed