Canterbury DHB

Context

Management of Leucostasis

Consider therapeutic leucopheresis in patients with life/organ threatening symptoms of leucostasis i.e.:

Consider rapid cytoreduction with hydroxyurea – high doses i.e. 4g bd may be required. Clinicians may choose to initiate cytoreduction whilst awaiting confirmation of the diagnosis, but it is not necessary to cytoreduce patients prior to introducing a TKI.

It is important to prevent and monitor for tumour lysis syndrome.

Avoid RBC transfusion whilst WBC is >100x109/L.

Note that patients with high WBC or platelet counts may have spurious hyperkalaemia. Check potassium levels in ABG tube (venous blood) delivered rapidly to the laboratory.

About this Canterbury DHB document (532024):

Document Owner:

Andrew Butler (see Who's Who)

Issue Date:

August 2018

Next Review:

April 2021

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 532024