Chronic lymphocytic leukemia presenting with extreme hyperleukocytosis and thrombosis of the common femoral vein
Chronic lymphocytic leukemia presenting with extreme hyperleukocytosis and thrombosis of the common femoral vein
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DOI：
10.1080/1042819021000006367
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发表时间：
2002-09-01
影响因子：
2.6
通讯作者：
Matzner, Y
中科院分区：
文献类型：
--
作者：
Cukierman, T;Gatt, ME;Matzner, Y
在医学文献中很少有关于慢性淋巴细胞白血病（CLL）和高白细胞血症的病例报告，也没有静脉血栓形成作为并发症的报道。在这里，我们描述了一个73岁的女性谁提出了新诊断的慢性淋巴细胞白血病，白细胞停滞，白细胞增多症（2000 × 10（9）/l），影响呼吸和神经系统。此外，她还患有深静脉血栓形成（DVT）。虽然高凝状态和血栓形成是实体瘤和骨髓增生性肿瘤中的常见现象，但CLL通常与获得性凝血病无关。我们假设，在我们的患者中，循环淋巴细胞的极端数量导致淋巴细胞的异常积聚，可能导致较大血管的淤滞和闭塞，在白细胞去除术后消退。此后，患者成功地维持了化疗。我们的结论是，白细胞去除术应被视为治疗慢性淋巴细胞白血病患者的主要并发症白细胞淤滞的选择。
Very few case reports dealing with chronic lymphocytic leukemia (CLL) and hyperleukocytosis have been reported in the medical literature and none with venous thrombosis as a complication. Here, we describe a 73-year-old woman who presented with newly diagnosed CLL, leukostasis, and hyperleukocytosis (2000 x 10(9)/l), affecting the respiratory and nervous system. In addition, she also had deep vein thrombosis (DVT). Although hypercoagulability and thrombosis are well-described phenomena in solid tumors and in myeloproliferative neoplasms, CLL is generally not associated with an acquired coagulopathy. We hypothesize that in our patient the extreme number of circulating lymphocytes resulted in an abnormal accumulation of lymphocytes possibly causing stasis and occlusion of a larger vessel, which resolved after leukopheresis. The patient has since been successfully maintained with chemotherapy. We conclude that leukopheresis should be considered as the therapy of choice in CLL patients presenting with major complications of leukostasis.