Skip to main content
SpringerLink
Log in

Emergencies in Acute Lymphoblastic Leukemia

  • Chapter
Acute Leukemias

Part of the book series: Hematologic Malignancies ((HEMATOLOGIC))

  • 2580 Accesses

Abstract

The clinical presentation of acute lymphoblastic leukemia (ALL) may range from nonspecific symptoms such as progressive malaise, fever, and fatigue to severe life-threatening manifestations, requiring immediate medical intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. O’Regan S, Carson S, Chesney RW, Drummond KN (1977) Electrolyte and acid-base disturbances in the management of leukemia. Blood 49(3):345–353

    PubMed  CAS  Google Scholar 

  2. Ten Harkel AD, Kist-Van Holthe JE, Van Weel M, Van der Vorst MM (1998) Alkalinization and the tumor lysis syndrome. Med Pediatr Oncol 31(1):27–28

    Article  PubMed  Google Scholar 

  3. Jones DP, Mahmoud H, Chesney RW (1995) Tumor lysis syndrome: Pathogenesis and management. Pediatr Nephrol 9(2):206–212

    Article  PubMed  CAS  Google Scholar 

  4. Spector T (1977) Inhibition of urate production by allopurinol. Biochem Pharmacol 26(5):355–358

    Article  PubMed  CAS  Google Scholar 

  5. Goldman SC, Holcenberg JS, Finklestein JZ, et al. (2001) A randomized comparison between rasburicase and allopurinol in children with lymphoma or leukemia at high risk for tumor lysis. Blood 97(10):2998–3003

    Article  PubMed  CAS  Google Scholar 

  6. Cairo MS, Bishop M (2004) Tumour lysis syndrome: New therapeutic strategies and classification. Br J Haematol 127(1):3–11

    Article  PubMed  Google Scholar 

  7. Brogard JM, Coumaros D, Franckhauser J, Stahl A, Stahl J (1972) Enzymatic uricolysis: A study of the effect of a fungal urate-oxydase. Rev Eur Etud Clin Biol 17(9):890–895

    PubMed  CAS  Google Scholar 

  8. Yeldandi AV, Yeldandi V, Kumar S, et al. (1991) Molecular evolution of the urate oxidase-encoding gene in hominoid primates: Nonsense mutations. Gene 109(2):281–284

    Article  PubMed  CAS  Google Scholar 

  9. Masera G, Jankovic M, Zurlo MG, et al. (1982) Urate-oxidase prophylaxis of uric acid-induced renal damage in childhood leukemia. J Pediatr 100(1):152–155

    Article  PubMed  CAS  Google Scholar 

  10. Pui CH, Relling MV, Lascombes F, et al. (1997) Urate oxidase in prevention and treatment of hyperuricemia associated with lymphoid malignancies. Leukemia 11(11):1813–1816

    Article  PubMed  CAS  Google Scholar 

  11. Patte C, Sakiroglu C, Ansoborlo S, et al. (2002) Urate-oxidase in the prevention and treatment of metabolic complications in patients with B-cell lymphoma and leukemia, treated in the Societe Francaise d’Oncologie Pediatrique LMB89 protocol. Ann Oncol 13(5): 789–795

    Article  PubMed  CAS  Google Scholar 

  12. Legoux R, Delpech B, Dumont X, et al. (1992) Cloning and expression in Escherichia coli of the gene encoding Aspergillus flavus urate oxidase. J Biol Chem 267(12):8565–8570

    PubMed  CAS  Google Scholar 

  13. Coiffier B, Mounier N, Bologna S, et al. (2003) Efficacy and safety of rasburicase (recombinant urate oxidase) for the prevention and treatment of hyperuricemia during induction chemotherapy of aggressive non-Hodgkin’s lymphoma: Results of the GRAAL1 (Groupe d’Etude des Lymphomes de l’Adulte Trial on Rasburicase Activity in Adult Lymphoma) study. J Clin Oncol 21(23):4402–4406

    Article  PubMed  CAS  Google Scholar 

  14. Lee AC, Li CH, So KT, Chan R (2003) Treatment of impending tumor lysis with single-dose rasburicase. Ann Pharmacother 37(11): 1614–1617

    Article  PubMed  Google Scholar 

  15. Trifilio S, Tallman M, Singhal S, Gordon L, Evens A, Mehta J (2004) Low-dose recombinant urate oxidase (rasburicase) is effective in hyperuricemia. 46th ASH Annual Meeting

    Google Scholar 

  16. Jeha S (2001) Tumor lysis syndrome. Semin Hematol 38(4 Suppl 10):4–8

    Article  PubMed  CAS  Google Scholar 

  17. Kelly KM, Lange B (1997) Oncologic emergencies. Pediatr Clin North Am 44(4):809–830

    Article  PubMed  CAS  Google Scholar 

  18. Sillos EM, Shenep JL, Burghen GA, Pui CH, Behm FG, Sandlund JT (2001) Lactic acidosis: A metabolic complication of hematologic malignancies: Case report and review of the literature. Cancer 92(9):2237–2246

    Article  PubMed  CAS  Google Scholar 

  19. Mazurek S, Boschek CB, Eigenbrodt E (1997) The role of phospho-metabolites in cell proliferation, energy metabolism, and tumor therapy. J Bioenerg Biomembr 29(4):315–330

    Article  PubMed  CAS  Google Scholar 

  20. Mathupala SP, Rempel A, Pedersen PL (1997) Aberrant glycolytic metabolism of cancer cells: A remarkable coordination of genetic, transcriptional, post-translational, and mutational events that lead to a critical role for type II hexokinase. J Bioenerg Biomembr 29(4):339–343

    Article  PubMed  CAS  Google Scholar 

  21. Elmlinger MW, Wimmer K, Biemer E, Blum WF, Ranke MB, Dannecker GE (1996) Insulin-like growth factor binding protein 2 is differentially expressed in leukaemic B-and T-cell lines. Growth Regul 6(3):152–157

    PubMed  CAS  Google Scholar 

  22. Cohick WS, Clemmons DR (1993) The insulin-like growth factors. Annu Rev Physiol 55:131–153

    Article  PubMed  CAS  Google Scholar 

  23. Werner H, LeRoith D (1996) The role of the insulin-like growth factor system in human cancer. Adv Cancer Res 68:183–223

    PubMed  CAS  Google Scholar 

  24. Durig J, Fiedler W, de Wit M, Steffen M, Hossfeld DK (1996) Lactic acidosis and hypoglycemia in a patient with high-grade non-Hodgkin’s lymphoma and elevated circulating TNF-alpha. Ann Hematol 72(2):97–99

    Article  PubMed  CAS  Google Scholar 

  25. Tiefenthaler M, Amberger A, Bacher N, et al. (2001) Increased lactate production follows loss of mitochondrial membrane potential during apoptosis of human leukaemia cells. Br J Haematol 114(3):574–580

    Article  PubMed  CAS  Google Scholar 

  26. Sculier JP, Nicaise C, Klastersky J (1983) Lactic acidosis: A metabolic complication of extensive metastatic cancer. Eur J Cancer Clin Oncol 19(5):597–601

    Article  PubMed  CAS  Google Scholar 

  27. Stacpoole PW (1986) Lactic acidosis: The case against bicarbonate therapy. Ann Intern Med 105(2):276–279

    PubMed  CAS  Google Scholar 

  28. Cooper DJ, Walley KR, Wiggs BR, Russell JA (1990) Bicarbonate does not improve hemodynamics in critically ill patients who have lactic acidosis. A prospective, controlled clinical study. Ann Intern Med 112(7):492–498

    PubMed  CAS  Google Scholar 

  29. Hingorani AD, Macdougall IC, Browne M, Walker RW, Tomson CR (1993) Successful treatment of acute D-lactate encephalopathy by haemodialysis. Nephrol Dial Transplant 8(11):1283–1285

    PubMed  CAS  Google Scholar 

  30. Barton IK, Streather CP, Hilton PJ, Bradley RD (1991) Successful treatment of severe lactic acidosis by haemofiltration using a bicarbonate-based replacement fluid. Nephrol Dial Transplant 6(5): 368–370

    PubMed  CAS  Google Scholar 

  31. Fukasawa H, Kato A, Fujigaki Y, Yonemura K, Furuya R, Hishida A (2001) Hypercalcemia in a patient with B-cell acute lymphoblastic leukemia: A role of proinflammatory cytokine. Am J Med Sci 322(2):109–112

    Article  PubMed  CAS  Google Scholar 

  32. Schneider T, Seydlitz F, Zimmermann U, Sontag B, Boesken WH (2001) [Life threatening hypercalcemia in a young man with ALL]. Dtsch Med Wochenschr 126(1/2):7–11

    Article  PubMed  CAS  Google Scholar 

  33. Lankisch P, Kramm CM, Hermsen D, Wessalowski R (2004) Hypercalcemia with nephrocalcinosis and impaired renal function due to increased Parathyroid hormone secretion at onset of childhood acute lymphoblastic leukemia. Leuk Lymphoma 45(8): 1695–1697

    Article  PubMed  Google Scholar 

  34. Esbrit P (2001) Hypercalcemia of malignancy — New insights into an old syndrome. Clin Lab 47(1/2):67–71

    PubMed  CAS  Google Scholar 

  35. Tan AW, Ng HJ, Ang P, Goh YT (2004) Extensive calcinosis cutis in relapsed acute lymphoblastic leukaemia. Ann Acad Med Singapore 33(1):107–109

    PubMed  CAS  Google Scholar 

  36. Schmid I, Stachel D, Schon C, Bauer M, Haas RJ (2001) Pamidronate and calcitonin as therapy of acute cancer-related hypercalcemia in children. Klin Padiatr 213(1):30–34

    Article  PubMed  CAS  Google Scholar 

  37. Bockman R (2003) The effects of gallium nitrate on bone resorption. Semin Oncol 30(2 Suppl 5):5–12

    Article  PubMed  CAS  Google Scholar 

  38. Warrell RP Jr, Murphy WK, Schulman P, O’Dwyer PJ, Heller G (1991) A randomized double-blind study of gallium nitrate compared with etidronate for acute control of cancer-related hypercalcemia. J Clin Oncol 9(8):1467–1475

    PubMed  Google Scholar 

  39. Chaves Alvarez AJ, Herrera Saval A, Marquez Enriquez J, Camacho Martinez F (2000) Metastatic calcinosis cutis in multiple myeloma. Br J Dermatol 142(4):820–822

    Article  PubMed  CAS  Google Scholar 

  40. Cochran RJ, Wilkin JK (1983) An unusual case of calcinosis cutis. J Am Acad Dermatol 8(1):103–106

    Article  PubMed  CAS  Google Scholar 

  41. Porcu P, Farag S, Marcucci G, Cataland SR, Kennedy MS, Bissell M (2002) Leukocytoreduction for acute leukemia. Ther Apher 6(1):15–23

    Article  PubMed  Google Scholar 

  42. Porcu P, Cripe LD, Ng EW, et al. (2000) Hyperleukocytic leukemias and leukostasis: A review of pathophysiology, clinical presentation and management. Leuk Lymphoma 39(1/2):1–18

    PubMed  CAS  Google Scholar 

  43. Strauss RA, Gloster ES, McCallister JA, Jimenez JF, Neuberg RW, Berry DH (1985) Acute cytoreduction techniques in the early treatment of hyperleukocytosis associated with childhood hematologic malignancies. Med Pediatr Oncol 13(6):346–351

    Article  PubMed  CAS  Google Scholar 

  44. Bunin NJ, Kunkel K, Callihan TR (1987) Cytoreductive procedures in the early management in cases of leukemia and hyperleukocytosis in children. Med Pediatr Oncol 15(5):232–235

    Article  PubMed  CAS  Google Scholar 

  45. Maurer HS, Steinherz PG, Gaynon PS, et al. (1988) The effect of initial management of hyperleukocytosis on early complications and outcome of children with acute lymphoblastic leukemia. J Clin Oncol 6(9):1425–1432

    PubMed  CAS  Google Scholar 

  46. Harousseau JL, Tobelem G, Schaison G, et al. (1980) High risk acute lymphocytic leukemia: A study of 141 cases with initial white blood cell counts over 100,000/cu mm. Cancer 46(9): 1996–2003

    Article  PubMed  CAS  Google Scholar 

  47. Lichtman MA, Heal J, Rowe JM (1987) Hyperleukocytic leukaemia: Rheological and clinical features and management. Baillieres Clin Haematol 1(3):725–746

    Article  PubMed  CAS  Google Scholar 

  48. Patte C, Philip T, Rodary C, et al. (1991) High survival rate in advanced-stage B-cell lymphomas and leukemias without CNS involvement with a short intensive polychemotherapy: Results from the French Pediatric Oncology Society of a randomized trial of 216 children. J Clin Oncol 9(1):123–132

    PubMed  CAS  Google Scholar 

  49. Lam JC, Chui CH, Jacobsen AS, Tan AM, Joseph VT (2004) When is a mediastinal mass critical in a child? An analysis of 29 patients. Pediatr Surg Int 20(3):180–184

    Article  PubMed  CAS  Google Scholar 

  50. Schindler N, Vogelzang RL (1999) Superior vena cava syndrome. Experience with endovascular stents and surgical therapy. Surg Clin North Am 79(3):683–694, xi

    Article  PubMed  CAS  Google Scholar 

  51. Abshire TC, Gold SH, Odom LF, Carson SD, Hathaway WE (1990) The coagulopathy of childhood leukemia. Thrombin activation or primary fibrinolysis? Cancer 66(4):716–721

    Article  PubMed  CAS  Google Scholar 

  52. Champion LA, Luddy RE, Schwartz AD (1978) Disseminated intravascular coagulation in childhood acute lymphocytic leukemia with poor prognostic features. Cancer 41(4):1642–1646

    Article  PubMed  CAS  Google Scholar 

  53. Ribeiro RC, Pui CH (1986) The clinical and biological correlates of coagulopathy in children with acute leukemia. J Clin Oncol 4(8):1212–1218

    PubMed  CAS  Google Scholar 

  54. Guarini A, Baccarani M, Corbelli G, Gugliotta L, Tura S (1980) Defibrination in adult acute lymphoblastic leukaemia. Report of four cases. Nouv Rev Fr Hematol 22(2):115–123

    PubMed  CAS  Google Scholar 

  55. Sarris AH, Kempin S, Berman E, et al. (1992) High incidence of disseminated intravascular coagulation during remission induction of adult patients with acute lymphoblastic leukemia. Blood 79(5):1305–1310

    PubMed  CAS  Google Scholar 

  56. Sarris A, Cortes J, Kantarjian H, et al. (1996) Disseminated intravascular coagulation in adult acute lymphoblastic leukemia: Frequent complications with fibrinogen levels less than 100 mg/dl. Leuk Lymphoma 21(1/2):85–92

    PubMed  CAS  Google Scholar 

  57. Higuchi T, Mori H, Niikura H, Omine M, Okada S, Terada H (1998) Disseminated intravascular coagulation in acute lymphoblastic leukemia at presentation and in early phase of remission induction therapy. Ann Hematol 76(6):263–269

    Article  PubMed  CAS  Google Scholar 

  58. Solano C, Lopez J, Gomez N, Fernandez-Ranada JM (1992) Acute lymphoblastic leukemia: Hypofibrinogenemia with a low incidence of clinical complications is often found during induction remission therapy. Blood 80(5):1366–1368

    PubMed  CAS  Google Scholar 

  59. Bezeaud A, Drouet L, Leverger G, Griffin JH, Guillin MC (1986) Effect of L-asparaginase therapy for acute lymphoblastic leukemia on plasma vitamin K-dependent coagulation factors and inhibitors. J Pediatr 108(5 Pt 1):698–701

    PubMed  CAS  Google Scholar 

  60. Ramsay NK, Coccia PF, Krivit W, Nesbit ME, Edson JR (1977) The effect of L-asparaginase of plasma coagulation factors in acute lymphoblastic leukemia. Cancer 40(4):1398–1401

    Article  PubMed  CAS  Google Scholar 

  61. Priest JR, Ramsay NK, Bennett AJ, Krivit W, Edson JR (1982) The effect of L-asparaginase on antithrombin, plasminogen, and plasma coagulation during therapy for acute lymphoblastic leukemia. J Pediatr 100(6):990–995

    Article  PubMed  CAS  Google Scholar 

  62. Bushman JE, Palmieri D, Whinna HC, Church FC (2000) Insight into the mechanism of asparaginase-induced depletion of antithrombin III in treatment of childhood acute lymphoblastic leukemia. Leuk Res 24(7):559–565

    Article  PubMed  CAS  Google Scholar 

  63. Bettigole RE, Himelstein ES, Oettgen HF, Clifford GO (1970) Hypofibrinogenemia due to L-asparaginase: Studies of fibrinogen survival using autologous 131-I-fibrinogen. Blood 35(2):195–200

    PubMed  CAS  Google Scholar 

  64. Nowak-Gottl U, Ahlke E, Klosel K, Jurgens H, Boos J (1997) Changes in coagulation and fibrinolysis in childhood acute lymphoblastic leukaemia re-induction therapy using three different asparaginase preparations. Eur J Pediatr 156(11):848–850

    Article  PubMed  CAS  Google Scholar 

  65. Cairo MS, Lazarus K, Gilmore RL, Baehner RL (1980) Intracranial hemorrhage and focal seizures secondary to use of L-asparaginase during induction therapy of acute lymphocytic leukemia. J Pediatr 97(5):829–833

    Article  PubMed  CAS  Google Scholar 

  66. Priest JR, Ramsay NK, Latchaw RE, et al. (1980) Thrombotic and hemorrhagic strokes complicating early therapy for childhood acute lymphoblastic leukemia. Cancer 46(7):1548–1554

    Article  PubMed  CAS  Google Scholar 

  67. Halton JM, Mitchell LG, Vegh P, Eves M, Andrew ME (1994) Fresh frozen plasma has no beneficial effect on the hemostatic system in children receiving L-asparaginase. Am J Hematol 47(3):157–161

    Article  PubMed  CAS  Google Scholar 

  68. Mauz-Korholz C, Junker R, Gobel U, Nowak-Gottl U (2000) Prothrombotic risk factors in children with acute lymphoblastic leukemia treated with delayed E. coli asparaginase (COALL-92 and 97 protocols). Thromb Haemost 83(6):840–843

    PubMed  CAS  Google Scholar 

  69. Mitchell LG, Andrew M, Hanna K, et al. (2003) A prospective cohort study determining the prevalence of thrombotic events in children with acute lymphoblastic leukemia and a central venous line who are treated with L-asparaginase: Results of the Prophylactic Antithrombin Replacement in Kids with Acute Lymphoblastic Leukemia Treated with Asparaginase (PARKAA) Study. Cancer 97(2): 508–516

    Article  PubMed  CAS  Google Scholar 

  70. Gugliotta L, Mazzucconi MG, Leone G, et al. (1992) Incidence of thrombotic complications in adult patients with acute lymphoblastic leukaemia receiving L-asparaginase during induction therapy: A retrospective study. The GIMEMA Group. Eur J Haematol 49(2):63–66

    Article  PubMed  CAS  Google Scholar 

  71. Benzon HT, Iqbal M, Tallman MS, Boehlke L, Russell EJ (2003) Superior sagittal sinus thrombosis in a patient with postdural puncture headache. Reg Anesth Pain Med 28(1):64–67

    Article  PubMed  Google Scholar 

  72. Duru F, Ertem U, Dagdemir A, et al. (1997) Coexistence of life threatening chemotherapy related leukoencephalopathy, sagittal sinus thrombosis and multiple organ failure in a child with acute lymphoblastic leukemia: An unusual case with clinical recovery. Leuk Lymphoma 26(3/4):377–385

    PubMed  CAS  Google Scholar 

  73. Corso A, Castagnola C, Bernasconi C (1997) Thrombotic events are not exclusive to the remission induction period in patients with acute lymphoblastic leukemia: A report of two cases of cerebral sinus thrombosis. Ann Hematol 75(3):117–119

    Article  PubMed  CAS  Google Scholar 

  74. Wetzler MS, Sanford BL, Owzar K (2005) Effective asparagine depletion with pegylated asparaginase results in improved outcomes in adult lymphoblastic leukemia (ALL)-CALGB 9511. Blood 106:519a

    Google Scholar 

  75. Douer D, et al. (2007) Pharmacodynamics and safety of intravenous pegaspargase during remission induction in adults aged 55 years or younger with newly diagnosed acute lymphoblastic leukemia. Blood 109(7):2744–2750

    PubMed  CAS  Google Scholar 

  76. Graham ML (2003) Pegaspargase: a review of clinical studies. Adv Drug Deliv Rev 55(10):1293–1302

    Article  PubMed  CAS  Google Scholar 

  77. Silverman LB, et al. (2001) Improved outcome for children with acute lymphoblastic leukemia: results of Dana-Farber Consortium Protocol 91-01. Blood 97(5):1211–1218

    Article  PubMed  CAS  Google Scholar 

  78. Gokbuget N, Hoelzer D (1998) Meningeosis leukaemica in adult acute lymphoblastic leukaemia. J Neurooncol 38(2/3):167–180

    Article  PubMed  CAS  Google Scholar 

  79. Kaikov Y (1996) Optic nerve head infiltration in acute leukemia in children: An indication for emergency optic nerve radiation therapy. Med Pediatr Oncol 26(2):101–104

    Article  PubMed  CAS  Google Scholar 

  80. Kataoka A, Shimizu K, Matsumoto T, et al. (1995) Epidural spinal cord compression as an initial symptom in childhood acute lymphoblastic leukemia: Rapid decompression by local irradiation and systemic chemotherapy. Pediatr Hematol Oncol 12(2):179–184

    Article  PubMed  CAS  Google Scholar 

  81. Schattner A, Kozack N, Sandler A, Shtalrid M (2001) Facial dysplasia as the presenting manifestation of acute lymphoblastic leukemia. Mt Sinai J Med 68(6):406–409

    PubMed  CAS  Google Scholar 

  82. Mayo GL, Carter JE, McKinnon SJ (2002) Bilateral optic disk edema and blindness as initial presentation of acute lymphocytic leukemia. Am J Ophthalmol 134(1):141–142

    Article  PubMed  Google Scholar 

  83. Beslac-Bumbasirevic L, Boskovic D, Tomin D, Colovic M, Kovacevic M, Bumbasirevic V (1996) Neuroleukemia in adults. Srp Arh Celok Lek 124(3/4):82–86

    PubMed  Google Scholar 

  84. Leibel SA, Phillips TL (1998) Textbook of radiation oncology. WB Saunders, Philadelphia

    Google Scholar 

  85. Storti S, Marra R, Pagano L, et al. (1988) Emergency abdominal surgery in patients with acute leukemia and lymphoma. Ital J Surg Sci 18(4):361–363

    PubMed  CAS  Google Scholar 

  86. Ferrara F, D’Ambrosio V, Di Noto R, Mele G, Giovine S, Romano L (1998) Spontaneous splenic rupture in a patient with acute lymphoblastic leukemia of Burkitt type. Leuk Lymphoma 29(5/6):613–616

    Article  PubMed  CAS  Google Scholar 

  87. Choo-Kang LR, Jones DM, Fehr JJ, Eskenazi AE, Toretsky JA (1999) Cerebral edema and priapism in an adolescent with acute lymphoblastic leukemia. Pediatr Emerg Care 15(2):110–112

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Olga Frankfurt

  2. Division of Hematology-Oncology Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA

    Martin S. Tallman

Authors
  1. Olga Frankfurt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin S. Tallman
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer Berlin Heidelberg

About this chapter

Cite this chapter

Frankfurt, O., Tallman, M.S. (2008). Emergencies in Acute Lymphoblastic Leukemia. In: Acute Leukemias. Hematologic Malignancies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-72304-2_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-72304-2_23

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-72302-8

  • Online ISBN: 978-3-540-72304-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation