Leukemoid reaction in malignant bone tumor patients - a retrospective, single-institution study.

Abstract

BACKGROUND:

To the Authors' knowledge, the literature regarding leukemoid reaction in patients with malignant bone tumor is sparse, and most of patients with leukemoid reaction have poor prognosis.

AIM:

To study the leukemoid reaction in malignant bone tumor patients.

MATERIALS AND METHODS:

A total of 105 consecutive malignant bone tumor patients with a white blood cell count > 50,000/microL were retrospectively identified over a 4-years period (2007-2010). Those patients without a secondary cause of their leukocytosis were defined as having a paraneoplastic leukemoid reaction.

RESULTS:

Three etiologies of the leukocytosis were found in those 105 patients: the major one was paraneoplastic leukemoid reaction which accounted for 56%; the second one was hematopoietic growth factors defect accounting for 30%; 14% patients were caused by infection and Tumor bone marrow involvement. The patients diagnosed with a paraneoplastic leukemoid reaction typically had neutrophil predominance (94.8%) and radiographic evidence of metastatic diseases (78%). They were clinically stable, but had a poor prognosis. 95% either died or were discharged to hospice within 12 weeks of their initial extreme leukocyte count. Both of the 2 (2%) patients who survived over 12 weeks received effective antineoplastic therapy.

CONCLUSIONS:

Patients with typical paraneoplastic leukemoid reaction were clinically stable despite having large tumor burdens. However, clinical outcomes were poor unless receiving an effective antineoplastic treatment.

• Authors: X Ma, G Li, Z Cai, W Sun, J Liu, F Zhang
• Journal: European review for medical and pharmacological sciences (Eur Rev Med Pharmacol Sci) Vol. 16 Issue 14 Pg. 1895-9 (Dec 2012) ISSN: 1128-3602 [Print] Italy
• PMID: 23242713 (Publication Type: Journal Article)

Chemical References

• Cytokines
• Hematopoietic Cell Growth Factors

Topics

• Adult
• Aged
• Bone Neoplasms (blood, complications, mortality, secondary, therapy)
• China
• Communicable Diseases (complications)
• Cytokines (blood)
• Female
• Hematopoietic Cell Growth Factors (blood)
• Humans
• Leukemoid Reaction (blood, diagnosis, etiology, mortality, therapy)
• Leukocytes
• Male
• Middle Aged
• Paraneoplastic Syndromes (blood, diagnosis, etiology, mortality, therapy)
• Prognosis
• Retrospective Studies
• Risk Factors
• Time Factors
• Tomography, X-Ray Computed