Citation, DOI, disclosures and article data
Citation:
Rezaee A, Weerakkody Y, Bell D, et al. Leukostasis. Reference article, Radiopaedia.org (Accessed on 28 Apr 2024) https://doi.org/10.53347/rID-36801
Leukostasis, also known as symptomatic hyperleukocytosis, is a medical emergency in patients with leukaemia, particularly acute myeloid leukaemia (AML) and in the blast phase of chronic myeloid leukaemia (CML), characterised by the over-accumulation of leukaemic 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.
It is most commonly seen as a complication of white blood cell counts over 100 x 109/L (100,000/microL) 4.
It needs to be considered in any patient with myelogenous leukaemia with an acute onset dyspnoea and normal chest radiograph or pulmonary oedema. Symptoms are due to obstruction of small pulmonary vessels or coronary artery(ies) by leukaemic cells.
Plain radiograph
Thoracic features include
- normal chest radiograph 4
- pulmonary oedema 4
- usually, no evidence of interstitial infiltrates
Treatment and prognosis
Leukostasis is an emergency and commonly managed with leukapheresis to remove the excess of leukaemic cells in circulation 4.
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1. Leis JF, Primack SL, Schubach SE et-al. Management of life-threatening pulmonary leukostasis with single agent imatinib mesylate during CML myeloid blast crisis. Haematologica. 2006;89 (9): ECR30. Pubmed citation
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2. Gavrilov VI. Acta Virol. 1976;19 (6): 510. Pubmed citation
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3. Webb WR, Higgins CB. Thoracic Imaging. Lippincott Williams & Wilkins. (2010) ISBN:1605479764. Read it at Google Books - Find it at Amazon
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4. 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
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5. Moon Hyung Choi, Jung Im Jung, Woong Do Chung, Yoo-Jin Kim, Sung-Eun Lee, Dae Hee Han, Myeong Im Ahn, Seog Hee Park. Acute Pulmonary Complications in Patients with Hematologic Malignancies. (2014) RadioGraphics. 34 (6): 1755-68. doi:10.1148/rg.346130107 - Pubmed
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6. van Buchem MA, Wondergem JH, Kool LJ, te Velde J, Kluin PM, Bode PJ, Busscher DL. Pulmonary leukostasis: radiologic-pathologic study. (1987) Radiology. 165 (3): 739-41. doi:10.1148/radiology.165.3.3479813 - Pubmed
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7. Ali A, Mirrakhimov A, Abboud C, Cashen A. Leukostasis in Adult Acute Hyperleukocytic Leukemia: A Clinician's Digest. Hematol Oncol. 2016;34(2):69-78. doi:10.1002/hon.2292 - Pubmed
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