» Articles » PMID: 38646395

Differentiating Leukostasis From COVID-19 Pneumonia: Clinical and Radiological Perspectives for the Right Decision-Making

Overview
Journal Cureus
Date 2024 Apr 22
PMID 38646395
Authors
Affiliations
Soon will be listed here.
Abstract

Leukostasis is a non-infectious complication of acute leukemia. Pathophysiologically, it is characterized by an accumulation of blasts in the pulmonary capillaries. Clinically, this syndrome of hyperleukocytosis or leucocytosis leads to pulmonary and/or neurological lesions. This is why it must be treated urgently to prevent it from progressing to acute respiratory distress. In 2020, the World Health Organization (WHO) declared a pandemic caused by a novel coronavirus called SARS-CoV-2, which may cause respiratory distress or other clinical, biological, and radiological signs that some may confuse with those of leukostasis. In this context, we present a compelling case study of a 64-year-old patient with no notable pathological antecedents and not vaccinated against COVID-19, who presented with acute respiratory distress. The purpose of our article is to succeed in differentiating between the two pneumopathies, thus making it possible to orient the doctor toward the right decision-making. As known, early recognition enables timely interventions, reducing disease progression and associated complications while also preventing unnecessary treatments, optimizing healthcare resources, and advancing medical knowledge for improved patient care in both acute leukemia and COVID-19 management.

References
1.
Voto C, Berkner P, Brenner C . Overview of the Pathogenesis and Treatment of SARS-CoV-2 for Clinicians: A Comprehensive Literature Review. Cureus. 2020; 12(9):e10357. PMC: 7549853. DOI: 10.7759/cureus.10357. View

2.
Rollig C, Ehninger G . How I treat hyperleukocytosis in acute myeloid leukemia. Blood. 2015; 125(21):3246-52. DOI: 10.1182/blood-2014-10-551507. View

3.
Byrd J, Mrozek K, Dodge R, Carroll A, Edwards C, Arthur D . Pretreatment cytogenetic abnormalities are predictive of induction success, cumulative incidence of relapse, and overall survival in adult patients with de novo acute myeloid leukemia: results from Cancer and Leukemia Group B (CALGB 8461). Blood. 2002; 100(13):4325-36. DOI: 10.1182/blood-2002-03-0772. View

4.
Ganzel C, Becker J, Mintz P, Lazarus H, Rowe J . Hyperleukocytosis, leukostasis and leukapheresis: practice management. Blood Rev. 2012; 26(3):117-22. DOI: 10.1016/j.blre.2012.01.003. View

5.
Fonseca E, Loureiro B, Strabelli D, Gomes de Farias L, Garcia J, Gama V . Evaluation of the RSNA and CORADS classifications for COVID-19 on chest computed tomography in the Brazilian population. Clinics (Sao Paulo). 2021; 76:e2476. PMC: 7979034. DOI: 10.6061/clinics/2021/e2476. View