title: The management of hyperleukocytosis in an adult patient with acute lymphoblastic leukemia and ataxia-telangiectasia.
abstract: Ataxia-telangiectasia (AT) is a hereditary disorder characterized by progressive neurological dysfunction, oculocutaneous telangiectasia, immunodeficiency, cancer susceptibility, and radiation sensitivity. Pediatric patients may develop acute lymphoblastic leukemia (ALL). However development of ALL in an adult patient with AT is a rare occurrence. Here we report such a patient who presented with hyperleukocytosis and were treated with leukapheresis. A 25years old male patient, who were diagnosed with AT and mental retardation, was admitted to the emergency department due to fatigue, nausea and headache. On admission he had a moderate general condition and was fully cooperated. His white blood cell (WBC) count were 466×10(9)/l. Blastic cells were observed in peripheral blood smear. Flow cytometry (FC) of peripheral blood showed T-ALL. Two sessions of large volume leukapheresis was performed. Symptoms due to hyperleukocytosis markedly improved after leukapheresis. Patients with AT should be closely monitored due to risk of malignancy. Leukapheresis may improve the prognosis of high risk ALL patients presenting with hyperleukocytosis.
authors.affiliation: Erciyes Stem Cell Transplantation Hospital, Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey. muzafferkeklik@yahoo.com
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Keklik
authors.forename: Serdar
authors.initials: S
authors.lastname: Sivgin
authors.forename: Burhan Sami
authors.initials: BS
authors.lastname: Kalin
authors.forename: Gulsah
authors.initials: G
authors.lastname: Akyol
authors.forename: Cigdem
authors.initials: C
authors.lastname: Pala
authors.forename: Musa
authors.initials: M
authors.lastname: Solmaz
authors.forename: Leylagul
authors.initials: L
authors.lastname: Kaynar
authors.forename: Bulent
authors.initials: B
authors.lastname: Eser
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cetin
authors.forename: Ali
authors.initials: A
authors.lastname: Unal
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001215:Asparaginase / Q000008:administration & dosage; D001260:Ataxia Telangiectasia / Q000150:complications* / Q000628:therapy*; D004317:Doxorubicin / Q000008:administration & dosage; D005434:Flow Cytometry; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D007937:Leukapheresis; D007964:Leukocytosis / Q000628:therapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000628:therapy*; D011379:Prognosis; D013256:Steroids / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D013256:Steroids; D014750:Vincristine; D004317:Doxorubicin; D001215:Asparaginase; D002955:Leucovorin; D008727:Methotrexate