Leukostasis: Management to Prevent Crisis in Acute Leukemia

Lisa M. Blackburn, MS, RN-BC, AOCNS®; Shelly Brown, MS, RN, AOCNS®; Aimee Munyon, RN, MS, CNP; Michelle Orovets, BSN, RN, OCN®


Background: Hyperleukocytosis, a peripheral white blood cell count greater than 100,000/mm3, is most commonly seen in patients with newly diagnosed or relapsed acute lymphoblastic leukemia and acute myeloid leukemia. Leukostasis is a reduction in blood flow related to hyperviscosity. Hyperleukocytosis, causing leukostasis, is an oncologic emergency and requires an exacting assessment and rapid response with appropriate intervention to prevent morbidity and mortality in the first week after diagnosis.

Objectives: The objectives of this article are to equip oncology nurse to identify patients with hyperleukocytosis and to provide nursing interventions that will ensure safe, quality care.

Methods: A case study is used to demonstrate key concepts that are critical in early assessment, identification, and treatment of patients with leukostasis.

Findings: Oncology nurses well versed in the pathophysiology, clinical presentation, and management of leukostasis can make a significant contribution to the safe management of patients with cancer.

View Article @ cjon.ons.org

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