ReviewCells2020
Hyperleukocytosis and Leukostasis in Acute Myeloid Leukemia: Can a Better Understanding of the Underlying Molecular Pathophysiology Lead to Novel Treatments?
Review in Cells, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
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Who cites it
45 citing papers in PubMed, 95 citations in OpenAlex.
- Endothelial Injury as a Potential Contributor to Cardiovascular Toxicity in Hematologic Malignancies.Diseases (Basel, Switzerland) · 2026Review
- Article
- Article
- Disease Subtype and Procedural Determinants of Leukapheresis Efficacy: A Retrospective Single-Center Study.Journal of clinical medicine · 2026Article
- Deciphering elevated risk of life-threatening hemorrhage and early death in acute myeloid leukemia with APL-like phenotype: independent role of endothelial injury and implications of EASIX-based risk stratification in a multicenter study.Journal of translational medicine · 2026Article
- Hyperleukocytosis and outcomes in pediatric B-cell acute lymphoblastic leukemia: A report from the REDIAL Consortium.medRxiv : the preprint server for health sciences · 2026Article
- Twenty Years of Therapeutic Leukocytapheresis in Newly Diagnosed Acute Myeloid Leukemia: Insights From A Single Center.Journal of clinical apheresis · 2026Article
- Central Nervous System Involvement in Acute Myeloid Leukemia: From Pathophysiology to Neuroradiologic Features and the Emerging Role of Artificial Intelligence.Journal of clinical medicine · 2026Review
- Risk factors for early mortality (within 6 weeks of diagnosis) in Chinese children with acute leukemia: a single-center retrospective cohort study.Annals of hematology · 2026Article
- T-cell lymphoma of the breast and ovary presenting as a second malignant neoplasm in a pediatric leukemia survivor: A case report and literature review.Rare tumors · 2026Article
- Spontaneous cardiac rupture as the initial presentation of acute myeloid leukaemia complicated by malignant lactic acidosis: a case report.European heart journal. Case reports · 2026Article
- Prediction model for survival outcome in patients with acute myeloid leukemia: a multicenter prospective cohort study from Thai Acute Leukemia Working Group.Frontiers in oncology · 2026Article
- Impact of Leukapheresis and Biological Risk Markers on Early Mortality in Patients with Hyperleukocytic Acute Myeloid Leukemia.Medicina (Kaunas, Lithuania) · 2025Article
- A Novel Approach to Prognostic Factors and Risk Stratification in Pediatric AML: Case Report and Literature Review.International journal of molecular sciences · 2025Review
- RUNX1 alterations and survival outcomes in AML: leukocyte dynamics and thrombocytosis insights from an Indonesian cohort.Blood research · 2025Article
- Article
- Does Time Matter From Diagnosis to Induction in Acute Myeloid Leukemia?Journal of hematology · 2025Article
- Multiple Organ Failure Due to Leukostasis Caused by Rapidly Progressive Hyperleukocytosis: A Case Report.Cureus · 2025Article
- Outcomes of Acute Kidney Injury Among Hospitalized Patients with Sepsis and Acute Myeloid Leukemia: A National Inpatient Sample Analysis.Journal of clinical medicine · 2025Article
- Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
Up to 18% of patients with acute myeloid leukemia (AML) present with a white blood cell (WBC) count of greater than 100,000/µL, a condition that is frequently referred to as hyperleukocytosis. Hyperleukocytosis has been associated with an adverse prognosis and a higher incidence of life-threatening complications such as leukostasis, disseminated intravascular coagulation (DIC), and tumor lysis syndrome (TLS). The molecular processes underlying hyperleukocytosis have not been fully elucidated yet. However, the interactions between leukemic blasts and endothelial cells leading to leukostasis and DIC as well as the processes in the bone marrow microenvironment leading to the massive entry of leukemic blasts into the peripheral blood are becoming increasingly understood. Leukemic blasts interact with endothelial cells via cell adhesion molecules such as various members of the selectin family which are upregulated via inflammatory cytokines released by leukemic blasts. Besides their role in the development of leukostasis, cell adhesion molecules have also been implicated in leukemic stem cell survival and chemotherapy resistance and can be therapeutically targeted with specific inhibitors such as plerixafor or GMI-1271 (uproleselan). However, in the absence of approved targeted therapies supportive treatment with the uric acid lowering agents allopurinol and rasburicase as well as aggressive intravenous fluid hydration for the treatment and prophylaxis of TLS, transfusion of blood products for the management of DIC, and cytoreduction with intensive chemotherapy, leukapheresis, or hydroxyurea remain the mainstay of therapy for AML patients with hyperleukocytosis.
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