Leukostasis in Children and Adolescents with Chronic Myeloid Leukemia: Japanese Pediatric Leukemia/Lymphoma Study Group.
BACKGROUND
The details of leukostasis in children and adolescents with chronic myeloid leukemia (CML) are unknown. This study determined the characteristics of leukostasis in children and adolescents with CML.


METHODS
A total of 256 cases from a retrospective study of patients with CML conducted by the Japanese Pediatric Leukemia/Lymphoma Study Group from 1996 to 2011 were analyzed, and of these, 238 cases were evaluated in this study.


RESULTS
Leukostasis was diagnosed in 23 patients (9.7%). The median leukocyte count and spleen size below the left costal margin in cases with leukostasis were significantly higher and larger when compared to those in cases without leukostasis (458.5 × 10(9) /l vs. 151.8 × 10(9) /l (P < 0.01), and 13 vs. 5 cm (P < 0.01), respectively). Leukostasis occurred with ocular symptoms in 14 cases, priapism in four cases, and dyspnea, syncope, headache, knee pain, difficulty hearing, and aseptic necrosis of the femoral head in one case each. One case had two leukostasis symptoms simultaneously. Three cases were diagnosed before imatinib became available. Five cases received special treatment, and in the remaining 15 cases, all of these symptoms resolved after treatment with imatinib.


CONCLUSIONS
This retrospective study represents the largest series of children and adolescents in which leukostasis of CML has been reported. Our data provide useful insight into the characteristics of leukostasis in recent cases of children and adolescents with CML.
Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan.
Hidemitsu
H
Kurosawa
Department of Pediatrics, University of Fukui Faculty of Medical Sciences, Fukui, Japan.
Akihiko
A
Tanizawa
Department of Pediatrics, Iwate Prefectural Chube Hospital, Iwate, Japan.
Chikako
C
Tono
Department of Pediatrics, Niigata Cancer Center Hospital, Niigata, Japan.
Akihiro
A
Watanabe
Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.
Haruko
H
Shima
Department of Pediatrics, Soma General Hospital, Fukushima, Japan.
Masaki
M
Ito
Department of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Yuki
Y
Yuza
Department of Pediatrics, Japan Community Healthcare Organization Tokuyama Central Hospital, Tokuyama, Japan.
Noriko
N
Hotta
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Hideki
H
Muramatsu
Department of Pediatrics, Nagasaki University School of Medicine, Nagasaki, Japan.
Masahiko
M
Okada
Department of Pediatrics, Yokohama City University, Yokohama, Japan.
Ryosuke
R
Kajiwara
Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Akiko
A
Moriya Saito
Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan.
Shuki
S
Mizutani
Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Souichi
S
Adachi
Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Keizo
K
Horibe
Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan.
Eiichi
E
Ishii
Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.
Hiroyuki
H
Shimada
D000293:Adolescent; D000970:Antineoplastic Agents; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D007951:Leukemia, Myeloid / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D018921:Leukostasis / Q000209:etiology*; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult
D000970:Antineoplastic Agents; D000068877:Imatinib Mesylate
CML; hyperleukocytosis; imatinib; leukostasis