RENAL VENOUS THROMBOSIS COMPLICATING ACUTE MYELOID-LEUKEMIA WITH HYPERLEUKOCYTOSIS

Purpose: Leukemic hyperleukocytosis may cause organ- or life-threateni ng complications. Patients at highest risk appear to be those with acu te myeloid leukemia (AML). Blast cell aggregation and thrombus formati on in the microvasculature most commonly involves the central nervous system and the pulmonary circulation. We describe a child with AML and renal venous thrombosis (RVT), a previously unreported complication o f hyperleukocytosis. Patients and Methods: A 17-month-old boy had a wh ite blood cell count of 103 X 10(9) cells/L and RVT (hematuria, arteri al systolic hypertension, unilateral nephromegaly, poor renal venous b lood flow) at diagnosis of acute myelomonocytic leukemia (AML, FAB M4) . Conclusion: This case emphasizes the danger of hyperleukocytosis in AML and demonstrates that there may be other organ system dysfunction in addition to the well-described central nervous system and pulmonary complications. Penal venous thrombosis should be considered in the pa tient with leukemic hyperleukocytosis, hematuria, arterial hypertensio n, and appropriate radiographic findings. Aggressive cytoreductive mea sures should be pursued in such cases.