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January 30, 1978

Spurious Elevation of the Platelet Count in Acute Leukemia

Author Affiliations

From the Departments of Medicine (Dr Armitage) and Pathology (Dr Goeken), University of Iowa Hospitals, Iowa City, and the Department of Medicine (Dr Feagler), University of Nebraska College of Medicine, Omaha.

JAMA. 1978;239(5):433-434. doi:10.1001/jama.1978.03280320049022

SYMPTOMS of acute leukemia are usually related to the absence of normal hemopoiesis. Bleeding related to thrombocytopenia and infection secondary to neutropenia are the most serious manifestations. Before the advent of platelet transfusions, bleeding was the most common cause of death in acute leukemia.1 More recently with the increasing availability of platelet transfusions and the ability to supply HLA-matched platelets, infection has replaced bleeding as the major cause of death.2 However, for platelet transfusions to have an impact on survival, the presence of thrombocytopenia must be recognized. In the case reported here, the recognition that bleeding symptoms were secondary to thrombocytopenia was delayed because of artifactually elevated platelet counts due to circulating fragments of leukemic cells.

Report of a Case  A 49-year-old farmer in whom leukemia had been diagnosed, had noticed increasing fatigue for six months and had been hospitalized locally one week earlier with pneumonia. His condition