Rapid Fire: Acute Blast Crisis/Hyperviscosity Syndrome

Emergency providers are likely to encounter patients with acute and chronic leukemias. In some cases, the first presentation to the emergency department may be for symptoms related to blast crisis and leukostasis. Making a timely diagnosis and consulting a hematologist can be life saving. Presenting...

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Bibliographic Details
Published inEmergency medicine clinics of North America Vol. 36; no. 3; p. 603
Main Authors Emerson, Geremiha, Kaide, Colin G
Format Journal Article
LanguageEnglish
Published United States 01.08.2018
Subjects
Hyperviscosity
Leukapheresis
Hydroxyurea
Leukostasis
Chronic myeloid leukemia
Petechiae
Blast
Acute myeloid leukemia
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Summary:Emergency providers are likely to encounter patients with acute and chronic leukemias. In some cases, the first presentation to the emergency department may be for symptoms related to blast crisis and leukostasis. Making a timely diagnosis and consulting a hematologist can be life saving. Presenting symptoms are caused by complications of bone marrow infiltration and hyperleukocytosis with white blood cell counts over 100,000. Presentations may include fatigue (anemia), bleeding (thrombocytopenia), shortness of breath, and/or neurologic symptoms owing to hyperleukocytosis and subsequent leukostasis. Treatment of symptomatic cases involves induction chemotherapy and/or leukapheresis. Asymptomatic hyperleukocytosis can be treated with hydroxyurea.
ISSN:1558-0539
DOI:10.1016/j.emc.2018.04.005