Tomaž Prelog1*, Ana Milojković2, Luka Camlek3, Janez Jazbec1, Marko Kavčič1, Lidija Kitanovski1 and Barbara Faganel Kotnik1
1Department of Oncology and Hematology, University Children's Hospital, University Medical Centre Ljubljana, Slovenia
2Blood Transfusion Centre of Slovenia, Slovenia
3Department of Pediatric Surgery and Intensive Care, University Children's Hospital, University Medical Centre Ljubljana, Slovenia
Hyperleukocytosis in children with acute lymphoblastic leukemia is a rare and potentially lifethreatening complication that has to be treated promptly with chemotherapy, hydroxyurea, leukapheresis or exchange transfusion. Many different studies gave conflicting results considering the best approach in patients with extremely high white blood cell count. We present a case report of an infant with MLL rearranged acute lymphoblastic leukemia, who presented with extreme hyperleukocytosis (white blood cell count of 2,000 × 109/L), and severe anemia (hemoglobin level of 3.9 g/dL), who was successfully treated with exchange transfusion, followed by chemotherapy according to Interfant 2006 protocol. The case report presents a successful treatment of an infant with extreme hyperleukocytosis and anemia and highlights the indications for exchange transfusion and leukapheresis.
Prelog T, Milojković A, Camlek L, Jazbec J, Kavčič M, Kitanovski L, et al. The Role of Plasmapheresis and Exchange Transfusion in Pediatric Acute Leukemia - Case Report of an Infant with Extreme Hyperleukocytosis. Ann Clin Case Rep. 2022; 7: 2279..