Pseudoleukemia: when "leukemia" is not leukemia

Several case reports6-8 in the literature have pointed out that a clinical and morphologic picture resembling that of acute leukemia may be secondary to infection or use of toxic drugs or alcohol. In these cases, the leukemic picture spontaneously returns to normal when the precipitating factor is no longer present. This condition has been termed pseudoleukemia. Unless the history of a precipitating factor is clear, the patient may be wrongly treated for leukemia. In the case reported here, initial findings suggested acute promyelocytic leukemia and chemotherapy was planned, but further investigation indicated that the condition was essentially reactive and related to a presumed viral infection. Even though pseudoleukemia is sometimes described as a leukemoid reaction, we believe that the term "pseudoleukemia" should be reserved for more specific differentiation.