Pseudoleukocytosis and pseudothrombocytosis caused by fragmentation of leukemic cells in tumor lysis syndrome

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  • HAGINO Takeshi
    Department of Hematology and Oncology, Jikei University Hospital
  • KAITO Ken
    Department of Central Clinical Laboratory, Jikei University Hospital
  • ASAI Osamu
    Department of Hematology and Oncology, Jikei University Hospital
  • DOBASHI Nobuaki
    Department of Hematology and Oncology, Jikei University Hospital
  • YANO Singo
    Department of Hematology and Oncology, Jikei University Hospital
  • TAKEI Yutaka
    Department of Hematology and Oncology, Jikei University Hospital
  • SUGIYAMA Katuki
    Department of Hematology and Oncology, Jikei University Hospital
  • SAITO Takeshi
    Department of Hematology and Oncology, Jikei University Hospital
  • OKAWA Yutaka
    Department of Hematology and Oncology, Jikei University Hospital
  • AIBA Keisuke
    Department of Clinical Oncology, Jikei University Hospital
  • USUI Noriko
    Department of Hematology and Oncology, Jikei University Hospital

Bibliographic Information

Other Title
  • 腫瘍崩壊症候群に伴う白血病細胞断片化による白血球数，血小板数の偽性高値
  • 症例報告 腫瘍崩壊症候群に伴う白血病細胞断片化による白血球数,血小板数の偽性高値
  • ショウレイ ホウコク シュヨウ ホウカイ ショウコウグン ニ トモナウ ハッケツビョウ サイボウ ダンペンカ ニ ヨル ハッケッキュウスウ ケッショウバンスウ ノ ギセイ コウチ

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Description

Tumor lysis syndrome (TLS) is a severe complication of chemotherapy brought about by the rapid destruction of tumor cells. TLS is usually diagnosed by elevation of intracellular enzymes and no specific abnormality is found in complete blood counts. We present a 22-year-old woman with acute lymphoblastic leukemia (ALL) complicated with TLS, in whom elevation of leukocytes and platelet count was observed due to fragmented leukocytes. The day after initiating chemotherapy, a rapid increase in intracellular enzymes was found and a diagnosis of TLS was made. Her leukocyte and platelet counts increased from 8,400/ml to 42,600/ml. and from 43,000/ml to 231,000/ml, respectively. Many fragmented leukocytes were found in her peripheral blood picture. The automated hematology analyzer counted these fragments as leukocytes or platelets, with resulting pseudo-leukocytosis and pseudo-thrombocytosis. When evaluating laboratory data of TLS, it is necessary to focus on the peripheral blood picture to avoid misunderstanding the blood cell counts.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 48 (12), 1559-1562, 2007

    The Japanese Society of Hematology

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