Pulmonary and cerebral leukostasis as an unusual case in a patient with chronic leukemia in chronic phase: Case report and literature review

Abstract

Hyperleukocytosis is defined as an absolute white blood cells count greater than 100.000cel/ml, being more common in acute myeloid leukemia (AML) than in chronic myeloid leukemia (CML). CML is the predominance of mature granulocytes, its main manifestation is hyperleukocytosis, that can increase the risk of pulmonary and cerebral leukostasis; although this event is uncommon in patients with CML in chronic phase. We present the case of a 38-year old male who presents with hyperleukocytosis that progress to hypoxemic respiratory failure and multiple intracerebral hemorrhage, treated with cytoreduction and tyrosine kinase inhibitors; without leukapheresis, with appropriate clinical evolution. Leukostasis is a high mortality complication that should be considered in patients with hyperleukocytosis who presents with neurological or respiratory distress, and constitutes a medical emergency in which treatment can’t be delayed.