Hyperleukocytosis and Exchange Transfusion in Pediatric Acute Leukemia: Literature Review

Rayhan Hafidz¹, Arina Setyaningtyas^2,3*

Abstract

Hyperleukocytosis is a life-threatening oncologic emergency frequently encountered in patients with acute leukemia. It is defined as a peripheral leukocyte count exceeding 100,000/µL and is most commonly observed in acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). This condition is associated with severe complications, including leukostasis, tumor lysis syndrome (TLS), and disseminated intravascular coagulation (DIC), which significantly contribute to early mortality. The management of hyperleukocytosis remains challenging due to its rapid progression and high risk of fatal complications. Current strategies focus on aggressive supportive care, prevention of metabolic disturbances, and rapid cytoreduction using leukapheresis, exchange transfusion, or early initiation of chemotherapy. This review summarizes current evidence regarding the clinical and laboratory manifestations, prognosis, complications, and management of hyperleukocytosis, emphasizing the importance of early recognition and individualized treatment to improve patient outcomes.

Keywords

acute leukemia; hyperleukocytosis; leukostasis; tumor lysis syndrome; exchange transfusion;  cytoreduction

Cite This Article

Hafidz, R., Setyaningtyas, A. (2026). Hyperleukocytosis and Exchange Transfusion in Pediatric Acute Leukemia: Literature Review. International Journal of Scientific Advances (IJSCIA), Volume 7| Issue 1: Jan – Feb 2026, Pages 132-138 URL: https://www.ijscia.com/wp-content/uploads/2026/02/Volume7-Issue1-Jan-Feb-No.1026-132-138.pdf

Volume 7 | Issue 1: Jan – Feb 2026