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Rapid Fire: Acute Blast Crisis/Hyperviscosity Syndrome

Geremiha Emerson1, Colin G Kaide1

  • 1Department of Emergency Medicine, Wexner Medical Center at The Ohio State University, 760 Prior Hall, 376 West 10th Avenue, Columbus, OH 43210, USA.

Emergency Medicine Clinics of North America
|July 25, 2018
PubMed

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.

Keywords:
Acute myeloid leukemiaBlastChronic myeloid leukemiaHydroxyureaHyperviscosityLeukapheresisLeukostasisPetechiae

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