Stress lysis in childhood leukemia.
Children with acute lymphoblastic leukemia (ALL) can experience a decrease in their white blood count (WBC) prior to chemotherapy, a phenomenon commonly attributed to the administration of allopurinol and hydration. We reviewed the records of 20 children with newly diagnosed ALL prior to the administration of allopurinol and found that 80% of patients experienced a decrease in their WBC (median decrease 14,000/mm(3)) in the less than 24-hr interval between evaluation at the referring center and admission to our hospital (P = 0.002). The basis for this often-observed phenomenon appears to be that leukemic cells rapidly lyse in response to the stress-induced release of endogenous corticosteroids.
Adamson
Peter C
PC
Division of Clinical Pharmacology & Therapeutics and Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. adamsonp@mail.med.upenn.edu
D002648:Child; D006760:Hospitalization; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D007958:Leukocyte Count; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D013312:Stress, Physiological / Q000150:complications*