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Current Hematologic Malignancy Reports Oct 2016Children with constitutional trisomy 21 (Down syndrome (DS)) have a unique predisposition to develop myeloid leukaemia of Down syndrome (ML-DS). This disorder is... (Review)
Review
Children with constitutional trisomy 21 (Down syndrome (DS)) have a unique predisposition to develop myeloid leukaemia of Down syndrome (ML-DS). This disorder is preceded by a transient neonatal preleukaemic syndrome, transient abnormal myelopoiesis (TAM). TAM and ML-DS are caused by co-operation between trisomy 21, which itself perturbs fetal haematopoiesis and acquired mutations in the key haematopoietic transcription factor gene GATA1. These mutations are found in almost one third of DS neonates and are frequently clinically and haematologcially 'silent'. While the majority of cases of TAM undergo spontaneous remission, ∼10 % will progress to ML-DS by acquiring transforming mutations in additional oncogenes. Recent advances in the unique biological, cytogenetic and molecular characteristics of TAM and ML-DS are reviewed here.
Topics: Down Syndrome; GATA1 Transcription Factor; Humans; Leukemia, Myeloid, Acute; Leukemoid Reaction; Risk; Stem Cell Transplantation
PubMed: 27510823
DOI: 10.1007/s11899-016-0338-x -
Journal of Clinical Pathology Jun 2020Paraneoplastic leukemoid reaction (PLR) is the extreme leukocytosis that occurs due to a non-haematolymphoid cytokine-secreting tumour (CST) in the absence of bone... (Review)
Review
Paraneoplastic leukemoid reaction (PLR) is the extreme leukocytosis that occurs due to a non-haematolymphoid cytokine-secreting tumour (CST) in the absence of bone marrow infiltration by that solid tumour. The clinical presentation is widely variable, and therefore challenging. If the underlying malignancy is not clinically apparent, PLR could be mistaken for myeloproliferative neoplasms, altering the patient's management. CSTs are highly aggressive tumours associated with a poor prognosis due to multiple mechanisms. Localising and treating the underlying malignancy is the mainstay of treatment. Both the treating clinician and the pathologist should keep a high level of suspicion for this entity in patients having unexplained leukocytosis. We herein discuss the underlying mechanisms, clinical presentation, pathological features, differential diagnosis and prognosis of this rare entity. An emphasis on the role of the pathologist is provided since the lack of knowledge on this entity can lead to dramatic effects on the patient, including unnecessary diagnostic testing and treatments.
Topics: Cytokines; Diagnosis, Differential; Humans; Leukemia, Myeloid; Leukemoid Reaction; Leukocytes; Myeloproliferative Disorders; Neoplasms; Prognosis
PubMed: 31941653
DOI: 10.1136/jclinpath-2019-206340 -
Cancer Immunology, Immunotherapy : CII Nov 2023Breast cancer is the leading malignancy in women worldwide, both in terms of incidence and mortality. Triple-negative breast cancer (TNBC) is the type with the worst...
Breast cancer is the leading malignancy in women worldwide, both in terms of incidence and mortality. Triple-negative breast cancer (TNBC) is the type with the worst clinical outcomes and with fewer therapeutic options than other types of breast cancer. GK-1 is a peptide that in the experimental model of the metastatic 4T1 breast cancer has demonstrated anti-tumor and anti-metastatic properties. Herein, GK-1 (5 mg/kg, i.v.) weekly administrated not only decreases tumor growth and the number of lung macro-metastases but also lung and lymph nodes micro-metastases. Histological analysis reveals that GK-1 reduced 57% of the intra-tumor vascular areas, diminished the leukemoid reaction's progression, and the spleens' weight and length. A significant reduction in VEGF-C, SDF-1, angiopoietin-2, and endothelin-1 angiogenic factors was induced. Moreover, GK-1 prevents T cell exhaustion in the tumor-infiltrating lymphocytes (TILs) decreasing PD-1 expression. It also increased IFN-γ and granzyme-B expression and the cytotoxic activity of CD8 TILs cells against tumor cells. All these features were found to be associated with a better antitumor response and prognosis. Altogether, these results reinforce the potential of GK-1 to improve the clinical outcome of triple-negative breast cancer immunotherapy. Translation research is ongoing towards its evaluation in humans.
Topics: Humans; Female; Animals; Mice; Triple Negative Breast Neoplasms; T-Cell Exhaustion; Lymphocytes, Tumor-Infiltrating; Prognosis; Antineoplastic Agents; CD8-Positive T-Lymphocytes
PubMed: 37736849
DOI: 10.1007/s00262-023-03538-9 -
Indian Pediatrics Feb 2021
Topics: Humans; Leukemoid Reaction; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Paraneoplastic Syndromes
PubMed: 33632959
DOI: No ID Found -
Cancer Immunology, Immunotherapy : CII Feb 2023Paraneoplastic leukemoid reaction (PLR) is a rare phenomenon in metastasized melanoma associated with poor prognosis and rapid disease progression. Currently, no...
BACKGROUND
Paraneoplastic leukemoid reaction (PLR) is a rare phenomenon in metastasized melanoma associated with poor prognosis and rapid disease progression. Currently, no specific therapeutic options exist other than treating the underlying malignancy.
METHODS
Five cases of paraneoplastic neutrophilia in patients with advanced-stage IV melanoma were enrolled in our study. Cytokine concentrations in patients' serum samples were analyzed before and during PLR using a multiplex cytokine array. Further, immunohistochemical staining of tumor tissue biopsied during PLR was performed.
RESULTS AND CONCLUSIONS
We observed a strong correlation between worsening of tumor burden and aggravation of neutrophilia. Cytokine measurements revealed an increase of proinflammatory cytokines (IL6, IFNγ), proangiogenic cytokines (VEGF) and immune stem cell growth factors (G-CSF) during PLR. Immunohistochemistry confirmed neutrophil infiltration of tumor tissue. The presented cytokine alterations provide a basis for further functional analysis, which is necessary for the development of targeted therapeutic approaches against PLR.
Topics: Humans; Cytokines; Leukemoid Reaction; Melanoma; Leukocytosis; Granulocyte Colony-Stimulating Factor; Prognosis; Neutrophils
PubMed: 35841421
DOI: 10.1007/s00262-022-03249-7 -
Cureus Sep 2021Leukemoid reaction is defined by a leukocyte level above 50 x 10/µL with a predominance of mature neutrophils and the presence of immature granulocytic forms in the...
Leukemoid reaction is defined by a leukocyte level above 50 x 10/µL with a predominance of mature neutrophils and the presence of immature granulocytic forms in the peripheral blood (left shift). We report a case of a 36-year-old woman with severe coronavirus disease 2019 (COVID-19) infection admitted to the ICU with a leukocytosis of 70.9 x 10/µL white blood cells (WBC) throughout her hospitalization. A left shift with bandemia along with toxic granulations was also noticed and further investigation excluded more commonly known causes. A presumptive diagnosis of leukemoid reaction was made secondary to COVID-19 infection; however, it could not be confirmed since workup for lymphoproliferative disorders could not be performed as the patient passed away. The leukemoid reaction could be associated with severe COVID-19 infection; however, more data are needed to evaluate this association.
PubMed: 34527502
DOI: 10.7759/cureus.17865 -
BMC Cancer Sep 2014The presentation of a leukemoid reaction in cervical cancers is rare. A leukemoid reaction is defined as leukocytosis associated with a cause outside the bone marrow,... (Review)
Review
BACKGROUND
The presentation of a leukemoid reaction in cervical cancers is rare. A leukemoid reaction is defined as leukocytosis associated with a cause outside the bone marrow, with the white blood cell count (WBC) exceeding 50*109/L. Two cervical cancers presenting with leukemoid reactions were previously reported. However, the cancers in these cases were mainly in the advanced stages and had a poor outcome.
CASE PRESENTATION
Here we report a 40-year old patient with clinical stage (FIGO IIA1) cervical squamous carcinoma suffering from vaginal cuff recurrence with a leukemoid reaction two months after laparoscopic radical hysterectomy. The patient suffered from persistent fever and leukocytosis after one month of antibiotic treatment accompanied by rapid growth of the vaginal mass indicated that the leukocytosis could not be caused only by infection. After paclitaxel injection, the WBC count increased to 70.37*109/L. Bone marrow aspirates and biopsy showed left-shift neutrophilia, which confirmed leukemoid reaction. After two courses of paclitaxel and cisplatin treatment, the white blood cell counts decreased to normal, the fever disappeared, and the vaginal mass was reduced dramatically. She achieved completed remission after subsequent chemo-radiation and two additional courses of chemotherapy.
CONCLUSION
In our case, leukemoid reaction was related to recurrent cervical carcinoma and sensitive to chemotherapy. To our knowledge, this is the third case to be reported in the literature. Furthermore, this is the only case described that shows an unequivocal correlation between tumor response and leukemoid reaction.
Topics: Adult; Biomarkers, Tumor; Biopsy; Female; Humans; Immunohistochemistry; Leukemoid Reaction; Leukocyte Count; Magnetic Resonance Imaging; Neoplasm Recurrence, Local; Treatment Outcome; Tumor Burden; Uterine Cervical Neoplasms
PubMed: 25223869
DOI: 10.1186/1471-2407-14-670 -
Cureus Dec 2023A leukemoid reaction is a rare condition characterized by an elevation in white blood cell count exceeding 50,000 cells/μL in response to severe medical conditions,...
A leukemoid reaction is a rare condition characterized by an elevation in white blood cell count exceeding 50,000 cells/μL in response to severe medical conditions, which can mimic the presentation of chronic myeloid leukemia (CML). Distinguishing between leukemoid reaction and CML depends on a thorough clinical history and comprehensive laboratory evaluation. We present a case of leukemoid reaction associated with severe diabetic ketoacidosis, where the patient's white blood cell count returned to the normal range after the correction of hyperglycemia and electrolyte imbalances.
PubMed: 38205495
DOI: 10.7759/cureus.50325 -
Cureus Mar 2021Hypersensitivity reactions to dapsone are common and potentially fatal adverse drug reactions. Herein, we report a case of a 45-year-old female who presented with fever,...
Hypersensitivity reactions to dapsone are common and potentially fatal adverse drug reactions. Herein, we report a case of a 45-year-old female who presented with fever, generalized desquamating rashes, and icterus three weeks after initiation of dapsone therapy for leprosy neuritis. She was diagnosed to have dapsone hypersensitivity syndrome (DHS) with leukemoid reaction and thrombocytosis. Dapsone was immediately discontinued, and she has treated with prednisolone 50 mg daily for a month and tapered over the next month. She has improved completely. DHS, leukemoid reaction, and severe thrombocytosis, or these adverse drug reactions to dapsone have rarely been reported.
PubMed: 33889465
DOI: 10.7759/cureus.14026 -
Cureus Feb 2021Leukemoid reaction is a rare clinical condition defined by marked leukocytosis with predominantly mature neutrophils. It is an uncommon condition with...
Leukemoid reaction is a rare clinical condition defined by marked leukocytosis with predominantly mature neutrophils. It is an uncommon condition with reported incidence of less than 1% in hospitalized patients. The major causes of leukemoid reaction are severe infection (clostridium difficile colitis, tuberculosis, or severe shigellosis), malignancies, intoxication, and severe hemorrhage. This article presents a case report of a 64-year-old female with severe COVID-19 infection who presented with marked leukocytosis. After extensive workup to exclude hematologic malignancy, the patient was diagnosed to have a leukemoid reaction.
PubMed: 33815998
DOI: 10.7759/cureus.13598