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November 1972

Fatal Pulmonary Leukostasis Following Treatment in Acute Myelogenous Leukemia

Author Affiliations


From Harvard Medical School (Drs. Lokich and Moloney), Peter Bent Brigham Hospital (Drs. Lokich and Moloney), and Children's Cancer Research Foundation (Dr. Lokich), Boston.

Arch Intern Med. 1972;130(5):759-762. doi:10.1001/archinte.1972.03650050079015

Leukemia is frequently associated with pulmonary complications which may be due to infection or to infiltration with leukemic cells either within the pulmonary parenchyma or obstructing the pulmonary vasculature.1 Vascular obstruction by emboli, as well as by leukostasis, may develop during the course of leukemia.2-7 The occurrence of rapid and fatal leukostasis in the pulmonary vasculature following therapy in two patients with acute myelogenous leukemia (AML) is described in this paper.

Patient Summaries 

Patient 1.  —A 75-year-old man was in excellent health until September 1970. At that time he developed acute abdominal pain and on admission to the hospital was found to have a white blood cell count (WBC) of 439,000/cu mm. The peripheral smear revealed 62% myeloblasts, but segmented neutrophils and metamyelocytes were also noted. The only significant finding on physical examination was moderate hepatosplenomegaly. The clinical impression was that this represented a patient with chronic myelogenous

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