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Acute Blast Crisis/Hyperviscosity Syndrome: Blasting Off!

  • Colin G. Kaide
  • Geremiha EmersonEmail author
Chapter

Abstract

Emergency providers are likely to encounter patients with acute and chronic leukemias. The first presentation to the ED may be for symptoms related to blast crisis and leukostasis. Making a timely diagnosis and immediately consulting a hematologist can be life-saving. Presenting symptoms are due to complications of bone marrow infiltration and hyperleukocytosis with WBC counts over 100,000. Presentations may include fatigue (anemia), bleeding (thrombocytopenia), shortness of breath, and/or neurological symptoms owing to hyperleukocytosis and subsequent leukostasis. Blast crisis with leukostasis is a Heme/Onc emergency. Treatment of symptomatic cases involves induction chemotherapy and/or leukapheresis. Asymptomatic hyperleukocytosis can be treated with hydroxyurea.

Keywords

Blast Leukstasis Leukapheresis Petechiae Hyperviscosity Chronic myeloid leukemia (CML) Acute myeloid leukemia (AML) Hydroxyurea 

Notes

Disclosure Statement

Geremiha Emerson has no disclosures. Colin Kaide: Callibra, Inc.-Discharge 123 medical software company. Medical Advisory Board Portola Pharmaceuticals. I have no relationship with a commercial company that has a direct financial interest in subject matter or materials discussed in article or with a company making a competing product.

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Emergency Medicine, Wexner Medical Center at The Ohio State UniversityColumbusUSA

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