According to Cairo and Bishop criteria, the laboratory TLS (LTLS), is present if >two of following abnormalities are present within three days before or up to seven days following chemotherapy, namely hyperuricemia (UA>8 mg/dl), hyperphosphatemia (P>6.5mg/dl), hyperkalemia (K>6 meq/L) and hypocalcemia (calcium 1.5 times the upper limit of normal and oliguria for 6 hours), features of leukostasis
(seizures, intracranial bleed), cardiac arrhythmias and death.1,5 The risk of TLS depends upon multiple factors like, aggressive nature/type of leukemia, stage of disease at diagnosis, leukemic burden, lactate dehydrogenase (LDH)level and regimen of chemotherapy and its chemo sensitivity in addition to dehydration, pre-existing renal damage and sepsis.
It addresses the causes and risk factors for each, the initial and confirmatory diagnostic tests, and treatment options, as well as the basics of blood and its components; the pathophysiology and classification of leukemias; epidemiology; etiology; staging and general management; supportive care; and emergencies like neutropenic sepsis, coagulopathy, tumor lysis syndrome, hyperleukocytosis and leukostasis
, differentiation syndrome, and asparaginase-related thromboses.
Prevention of leukostasis
and vascular leakage in streptozotocin-induced diabetic retinopathy via intercellular adhesion molecule-1 inhibition.
Acute myeloid leukemia (AML) is a hematopoietic neoplasm of the myeloid line of blood cells. Clinically, secondary heart tumors usually remain silent. Several mechanisms have been suggested for the occurrence of cardiovascular disease during acute leukemia: leukemic thrombi or leukostasis
in major arteries, leukemic infiltration into the myocardium or pericardium, and disorders of coagulation secondary to leukemia and antileukemic therapies. We present a case of intracavitary heart masses in three heart chambers by AML.
Although in most cases, extreme hyperleukocytosis has been shown to be self-limiting without intervention, as in our patient, close monitoring is warranted for complications of leukostasis
and acute kidney injury secondary to rapid cytolysis .
Could this patient have had pulmonary leukostasis
refers to hyperleukocytosis combined with organ failure in a patient with extreme blast counts.
ICAM-1 knockout or pharmaceutical blockade attenuated DR features such as retinal leukostasis
and vascular leakage in diabetic animals [24,27].
Patel, "Targeting leukostasis
for the treatment of early diabetic retinopathy," Cardiovascular & Hematological Disorders Drug Targets, vol.
Stimulated WBCs have an increased tendency to adhere to vascular endothelium, and they easily penetrate the intima, causing both capillary leukostasis
and increased vascular resistance.,, Additionally, stimulated WBCs release a variety of hydrolytic enzymes, cytokines, and growth factors, which can induce further vascular damage., Particularly in SLE, patients possess a distinct granulocyte population named low-density granulocytes (LDGs); these cells exhibit an enhanced capacity to synthesize pro-inflammatory cytokines, including type I interferons, and LDGs are significantly toxic to endothelial cells., Additionally, the NLR could reflect the autonomic balance and subsequent chronic inflammation of the vascular bed.
Acute pulmonary edema due to recent NSTEMI, bilateral pneumonia (blood culture later reported as positive for Staphylococcus epidermidis), leukostasis
, and differentiation syndrome were considered in the differential diagnoses.
Zhong et al., "TNFalpha is required for late BRB breakdown in diabetic retinopathy, and its inhibition prevents leukostasis
and protects vessels and neurons from apoptosis," Investigative Ophthalmology & Visual Science, vol.