Acute myeloid leukemia
ICD-10 C92.0 · ICD-11 2A60

Treatment of Non-APL AML with WBC Count >100 × 109/L and Signs of Leukostasis

In non-APL acute myeloid leukaemia, a markedly elevated white blood cell count — exceeding 100 × 109/L — accompanied by signs of leukostasis represents an urgent clinical situation in which cytoreduction must be considered promptly.

Clinical scenario

Non-APL AML with WBC count >100 × 109/L and signs of leukostasis. This presentation requires rapid assessment of the need for cytoreduction.

Treatment goals

Reduction of the white blood cell count and resolution of leukostasis.

Approach (partial overview)

Management centres on cytoreduction, with the selection of agent guided by whether the patient is able to take oral medication. The complete structured regimen — including specific agents, indications for leukapheresis, and accompanying therapy — is available via the protocol link below.

Instant Access to Structured Evidence-Based Regimens

References

  1. In patients with non-APL AML with a white blood cell (WBC) count >100 × 109/l and signs of leukostasis, the requirement for cytoreduction should be considered.
  2. This is achieved with 50–60 mg/kg hydroxycarbamide per day, or, if a patient cannot swallow, either with intravenous (i.v.) or subcutaneous cytarabine, or with i.v. daunorubicin.
  3. Nevertheless, if leukapheresis is applied, it should be accompanied by hydroxycarbamide, cytarabine or daunorubicin.
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