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Updated: Aug 15, 2026
Pre-clinical Evaluation of Tyrosine Kinase Inhibitors for Treatment of Acute Leukemia
Published on: September 18, 2013
[Atypical presentation of acute myeloblastic leukemia in two pediatric patients]
J L Pérez Navero1, L Marroquín Yáñez, I Ibarra De La Rosa
1Unidad de Cuidados Intensivos Pediátricos, Servicio de Críticos y Urgencias Pediátricas, Hospital Universitario Reina Sofia, Cordoba, Spain.
Abstract:
Acute myeloblastic leukemia (MLA) is an uncommon disease in childhood and its prognosis is worse than that of lymphoblastic leukemia. Severe hemorrhage, infections and perfusion disorders secondary to leukostasis are the main complications leading to its high mortality rate. Two pediatric patients with MLA (M5a and M2) are presented. Both patients were admitted to the pediatric intensive care unit with acute respiratory distress syndrome and intracranial hemorrhage respectively, secondary to leukostasis. The first patient showed favorable clinical course and underwent bone marrow transplantation four months later; in contrast, the second patient died a few hours after admission. The physiopathology of each case, the therapeutic approach and the use of leukopheresis as a therapeutic alternative in patients with hyperleukocytosis and leukostasis are discussed. A high degree of suspicion is required to make a diagnosis as early as possible in order to avoid the death of a large percentage of patients before cytostatic treatment begins.
Insights
Acute myeloblastic leukemia (AML) in children is rare and aggressive. Early diagnosis and intervention, including leukopheresis for hyperleukocytosis, are crucial for improving survival rates in pediatric AML patients.
Area of Science:
- Pediatric Hematology Oncology
- Leukemia Pathophysiology
- Critical Care Medicine
Background:
- Acute myeloblastic leukemia (AML) presents a poorer prognosis in children compared to lymphoblastic leukemia.
- Leukostasis, a complication of hyperleukocytosis, leads to severe hemorrhage, infections, and perfusion disorders, contributing to high AML mortality.
- Prompt diagnosis is essential to initiate cytostatic treatment and prevent fatal outcomes.
Observation:
- Two pediatric cases of AML (M5a and M2) are presented.
- One patient experienced acute respiratory distress syndrome, while the other suffered intracranial hemorrhage due to leukostasis.
- One patient had a favorable outcome with bone marrow transplantation, while the other demised shortly after admission.
Findings:
- Leukostasis significantly contributes to the high mortality rate in pediatric AML.
- Leukopheresis is discussed as a potential therapeutic alternative for hyperleukocytosis and leukostasis.
- Early clinical suspicion and diagnosis are paramount for timely intervention.
Implications:
- Highlights the critical need for heightened clinical suspicion for pediatric AML.
- Emphasizes the role of prompt diagnosis and aggressive management, including potential use of leukopheresis.
- Suggests improved survival strategies for pediatric patients with AML and leukostasis.
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