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Leukostasis in Children and Adolescents with Chronic Myeloid Leukemia: Japanese Pediatric Leukemia/Lymphoma Study Group
Author(s) -
Kurosawa Hidemitsu,
Tanizawa Akihiko,
Tono Chikako,
Watanabe Akihiro,
Shima Haruko,
Ito Masaki,
Yuza Yuki,
Hotta Noriko,
Muramatsu Hideki,
Okada Masahiko,
Kajiwara Ryosuke,
Moriya Saito Akiko,
Mizutani Shuki,
Adachi Souichi,
Horibe Keizo,
Ishii Eiichi,
Shimada Hiroyuki
Publication year - 2016
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25803
Subject(s) - leukostasis , medicine , retrospective cohort study , hemophagocytic lymphohistiocytosis , myeloid leukemia , hemophagocytosis , leukemia , myeloid , avascular necrosis , surgery , pediatrics , bone marrow , femoral head , disease , pancytopenia
Background The details of leukostasis in children and adolescents with chronic myeloid leukemia (CML) are unknown. This study determined the characteristics of leukostasis in children and adolescents with CML. Procedure A total of 256 cases from a retrospective study of patients with CML conducted by the Japanese Pediatric Leukemia/Lymphoma Study Group from 1996 to 2011 were analyzed, and of these, 238 cases were evaluated in this study. Results Leukostasis was diagnosed in 23 patients (9.7%). The median leukocyte count and spleen size below the left costal margin in cases with leukostasis were significantly higher and larger when compared to those in cases without leukostasis (458.5 × 10 9 /l vs. 151.8 × 10 9 /l ( P < 0.01), and 13 vs. 5 cm ( P < 0.01), respectively). Leukostasis occurred with ocular symptoms in 14 cases, priapism in four cases, and dyspnea, syncope, headache, knee pain, difficulty hearing, and aseptic necrosis of the femoral head in one case each. One case had two leukostasis symptoms simultaneously. Three cases were diagnosed before imatinib became available. Five cases received special treatment, and in the remaining 15 cases, all of these symptoms resolved after treatment with imatinib. Conclusions This retrospective study represents the largest series of children and adolescents in which leukostasis of CML has been reported. Our data provide useful insight into the characteristics of leukostasis in recent cases of children and adolescents with CML.