II. Definitions
- Blast Crisis
- Chronic Myelogenous Leukemia late stage progression to >20% blasts in blood or marrow
- Results in very high White Blood Cell Counts, Anemia, infection risk, Leukostasis, Tumor Lysis Syndrome
III. Mechanism
- Late complication of Chronic Myelogenous Leukemia (CML)
- Lymphoblasts increase in the Bone Marrow at the expense of other cell lines
- White Blood Cells increase causing Leukostasis resulting in end organ decreased perfusion
IV. Complications
-
Anemia
- Avoid Blood Transfusion if possible (may worsen Blast Crisis)
- pRBC Transfuse for hemodynamic instability or uncontrolled Hemorrhage
-
Thrombocytopenia
- Spontaneous Intracranial Hemorrhage risk when Platelet Count <20,000
- Platelet Transfusion for Platelet Count <20,000 (<50,000 if current bleeding)
- Increased infection risk
- Functional Neutropenia or Immunocompromised
- Treat focal infections with broad spectrum antibiotics
-
Leukostasis (Hyperviscosity Syndrome)
- See Leukostasis for management
- CNS and cardiac hypoperfusion from sludging of white cells (>50,000/ul)
- Presents with Altered Mental Status, CVA, CHF or Pulmonary Edema
-
Tumor Lysis Syndrome
- See Tumor Lysis Syndrome for management
- Presents with fever, Fatigue, weakness, Nausea, Vomiting
- Rapid cell death and turnover resulting Electrolyte abnormalities
V. References
- Dubbs and Swaminathan in Swadron (2021) Crit Dec Emerg Med 21(12): 18-20
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Related Studies
| Concepts | Pathologic Function (T046) |
| Italian | Linfoblastosi |
| Japanese | リンパ芽球症, ﾘﾝﾊﾟｶﾞｷｭｳｼｮｳ |
| Czech | Lymfoblastóza |
| English | Lymphoblastosis |
| Hungarian | lymphoblastosis |
| Portuguese | Linfoblastose |
| Spanish | Linfoblastosis |
| Dutch | lymfoblastose |
| French | Lymphoblastose |
| German | Lymphoblastose |
Ontology: Blast crisis in myelogenous leukaemia (C0919644)
| Concepts | Neoplastic Process (T191) |
| Italian | Crisi blastica in leucemia mieloide |
| French | Crise blastique de leucémie myéloïde, Crise blastique de la leucémie myélogène |
| Portuguese | Crise de blastos em leucemia mielogénica, Crise blástica na leucemia mielogenosa |
| Japanese | 骨髄性白血病の芽球発症, ｺﾂｽﾞｲｾｲﾊｯｹﾂﾋﾞｮｳﾉｶﾞｷｭｳﾊｯｼｮｳ |
| Czech | Blastická krize u myeloidní leukemie |
| Hungarian | Blastos crisis myelogen leukemiában, Blast crisis myelogen leukaemiában |
| English | Blast crisis in myelogenous leukaemia, Blast crisis in myelogenous leukemia |
| Spanish | Crisis blástica en leucemia mielógena |
| Dutch | blastencrisis in myelogene leukemie |
| German | Blastenkrise bei myeloischer Leukaemie |
