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. 2024 Sep 1;13(17):5185.
doi: 10.3390/jcm13175185.

Hyperleukocytosis in Pediatric Patients with Acute Lymphoblastic Leukemia: Demographic and Clinical Characteristics

Małgorzata Monika Mitura-Lesiuk  1 , Maciej Dubaj  2 , Aleksandra Dembowska  2 , Karol Bigosiński  2 , Mateusz Raniewicz  2
Affiliations

Hyperleukocytosis in Pediatric Patients with Acute Lymphoblastic Leukemia: Demographic and Clinical Characteristics

Małgorzata Monika Mitura-Lesiuk et al. J Clin Med. .

Abstract

Background: Hyperleukocytosis, defined as a total leukocyte count of more than 50,000/mm3 leukocytes, occurs in almost one in five children with acute lymphoblastic leukemia (ALL). It represents an unfavorable prognostic factor in this disease. The aim of the following study was to describe demographic and clinical features in patients with hyperleukocytosis and their relationship with leukocyte count. Methods: We retrospectively analyzed the available medical data of patients with ALL diagnosed and treated at the University Children's Hospital in Lublin between 2017 and 2024. Results: Of the 97 patients, 10 (10.3%) had hyperleukocytosis. They were significantly more likely to be older boys diagnosed with T-ALL. The group with hyperleukocytosis had a higher mortality rate. The presence of hyperleukocytosis also correlated with the presence of petechiae, thrombocyte and neutrophil counts, and LDH activity. Patients with hyperleukocytosis also experienced a higher incidence of infections as a complication of therapy as leukocyte counts increased. Conclusions: Hyperleukocytosis, although rare, is an important factor in the course of ALL, both clinically and prognostically.

Keywords: acute lymphoblastic leukemia; children; hyperleukocytosis; prognosis; risk factor.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Distribution of patients with and without hyperleukocytosis by gender. (b) Distribution of patients with and without hyperleukocytosis by type of leukemia; (c) distribution of patients with and without hyperleukocytosis by occurrence of death.
Figure 2
Figure 2
The box-whisker chart showing the relationship between petechiae occurrence (1), absence (0) and white blood cell (WBC) counts in patients with hyperleukocytosis.
Figure 3
Figure 3
(a) Correlation between petechiae occurrence and white blood cell (WBC) counts in patients with hyperleukocytosis; (b) correlation between maximal white blood cell (WBC) counts and white blood cell (WBC) counts at the moment of admission in patients with hyperleukocytosis; (c) correlation between neutrophil (NEUTR) counts and white blood cell (WBC) counts in patients with hyperleukocytosis; (d) correlation between platelet counts (PLT) and white blood cell (WBC) counts in patients with hyperleukocytosis; and (e) correlation between lactate dehydrogenase (LDH) level and white blood cell (WBC) counts in patients with hyperleukocytosis.
Figure 4
Figure 4
A box chart showing the relationship between the presence (1) and absence (0) of infections and white blood cell (WBC) counts in patients with hyperleukocytosis.
Figure 5
Figure 5
Correlation between white blood cell (WBC) counts and the occurrence of infections in patients with hyperleukocytosis.
See this image and copyright information in PMC

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