Leukemic cell lysis pneumopathy

Last revised by Bruno Di Muzio on 22 Mar 2019

Leukemic cell lysis pneumopathy, also referred to as acute lysis pneumopathy, refers to an acute respiratory failure that can occur in patients with leukemia after the initiation of chemotherapy, particularly in those with hyperleukocytosis. On imaging, it manifests with features of acute respiratory distress syndrome (ARDS)

It is commonly seen in those patients with high leukocytes count, over leukocyte counts, 200,000/mL 2,4

It presents an acute onset of respiratory failure usually seen within 48 hours from the start of chemotherapy 4.  Associated fevers and hemoptysis have been described 4.

This pneumopathy presents with imaging features of acute respiratory distress syndrome (ARDS) and diffuse alveolar damage 1-2,4, including extensive areas of pulmonary consolidation 2

Life-supportive measures, with these patients usually admitted to ICU. Steroids, although controversial, are commonly used.   

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