A rare complication of leukostasis with AML M4 patient: Microcirculatory dysfunction of upper extremities

Transfus Apher Sci. 2023 Aug;62(4):103717. doi: 10.1016/j.transci.2023.103717. Epub 2023 May 2.

Abstract

Background: In children with acute myeloid leukemia, the incidence of hyperleukocytosis is 5-33%. Patients with AML and hyperleukocytosis have a higher early mortality rate than patients with nonhyperleukocytic AML because of the increased risk of severe pulmonary and neurologic complications. Leukapheresis provides rapid cytoreduction and reduces early mortality rates.

Case presentation: In this report, we present a case with microcirculatory failure of upper extremities as a rare symptom of hyperleukocytic AML M4 at initial presentation.

Conclusions: Early diagnosis and treatment of patients with AML admitted to emergency services with these symptoms is too important to prevent from loss of extremities. Most of the complications of hyperleukocytosis can be reversible with early treatment.

Keywords: Early complication; Leukapheresis; Leukostasis; Pediatric AML.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Humans
  • Leukapheresis
  • Leukemia, Myeloid, Acute* / complications
  • Leukemia, Myeloid, Acute* / diagnosis
  • Leukemia, Myeloid, Acute* / therapy
  • Leukocytosis / therapy
  • Leukostasis* / etiology
  • Leukostasis* / prevention & control
  • Microcirculation
  • Upper Extremity