title: Severe hyperleukocytosis and multifocal intracranial haemorrhage: not always a fatal outcome.
abstract: Severe hyperleukocytosis caused by acute lymphoblastic leukaemia (ALL) is associated with an increased risk of early death due to the intracranial haemorrhage. We report on a boy who presented with ALL with an extremely high leukocyte count, who developed neurological deterioration due to multiple intracerebral haemorrhages. Adequate measures for managing this medical emergency include appropriate supportive measures and initiation of therapy to prevent symptoms of leukostasis. Aggressive measures as a decompressive craniectomy should be considered to improve the poor outcome observed in this subset of patients.
authors.affiliation: Division of Paediatric Oncology, Catholic University of Rome, Largo A. Gemelli 8, 00168, Rome, Italy. ruggiero@rm.unicatt.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ruggiero
authors.affiliation: Division of Paediatric Oncology, Catholic University of Rome, Largo A. Gemelli 8, 00168, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Attinà
authors.affiliation: Pediatric Intensive Care Unit, Catholic University of Rome, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Piastra
authors.affiliation: Division of Paediatric Oncology, Catholic University of Rome, Largo A. Gemelli 8, 00168, Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Maurizi
authors.affiliation: Division of Paediatric Oncology, Catholic University of Rome, Largo A. Gemelli 8, 00168, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Mastrangelo
authors.affiliation: Pediatric Intensive Care Unit, Catholic University of Rome, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Pietrini
authors.affiliation: Division of Paediatric Oncology, Catholic University of Rome, Largo A. Gemelli 8, 00168, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Riccardi
mesh_terms: D002675:Child, Preschool; D019299:Decompression, Surgical; D006801:Humans; D020300:Intracranial Hemorrhages / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D007958:Leukocyte Count; D007964:Leukocytosis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D011859:Radiography; D012074:Remission Induction