Advanced Practice

Hyperleukocytosis in Acute Myeloid Leukemia: Considerations for Inpatient Diagnosis and Management

Tia T. Wheatley

Haley Foster Castiglione

Kenneth Phong

Monica Yoon

hyperleukocytosis, leukostasis, acute myeloid leukemia, tumor lysis syndrome
CJON 2023, 27(6), 589-593. DOI: 10.1188/23.CJON.589-593

Hyperleukocytosis, a white blood cell count greater than 100,000/mcl, can be associated with the following three primary oncologic emergencies: leukostasis, disseminated intravascular coagulation, and tumor lysis syndrome. These complications significantly increase a patient’s risk of morbidity and mortality. Therefore, timely evidence-based interventions ensure patient safety. This article provides clinical evidence and guidelines for advanced practice nurses working in hematology-oncology to support diagnostic workup and management of hyperleukocytosis in patients with acute myeloid leukemia. A patient case study demonstrates key concepts.


  • Hyperleukocytosis can lead to several oncologic emergencies for patients with newly diagnosed acute myeloid leukemia.
  • Prompt recognition and management of leukostasis can prevent early complications.
  • Advanced practice nurses can use evidence-based strategies for ongoing monitoring and intervention to preserve patient safety.
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