A case report of therapeutic leukapheresis in an adult with chronic myelogenous leukemia presenting with hyperleukocytosis and leukostasis.

Hyperleukocytosis (>100 x 10(9)/L) is an uncommon presentation of chronic leukemias. It can present with a variety of symptoms secondary to leukostasis, a syndrome caused by the sludging of circulating leukemic blasts in the microvasculature. The management includes hydration, cytoreduction, prevention of tumor lysis and, rarely, leukapheresis in cases complicated by leukostasis and hyperviscosity syndrome. We present a case of severe leukocytosis complicated by leukostasis in which leukapheresis was utilized to bring about a rapid reversal of microvascular sludging.