This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Neoplastic disorders of WBCs, Subject name: Pediatrics
[{'content': 'A child with acute myeloid leukemia presents with hyperleukocytosis. Treatment includes all of the following EXCEPT: \nSelect and explain. \nA. IV fluid, B. Allopurinol, C. Alkalinization, D. Immediately sta induction chemotherapy', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Hyperleukocytosis: - Leukocyte count > 100,000/uL - It is medical emergency most commonly seen with AML or CML in blast crisis - There is sludging of blasts in microcirculation - obstruction of small vessels especially in brain & lungs - Treatment: IV fluids (hydration) Alkalinization Allopurinol (to prevent tumor lysis syndrome) Hydroxyurea (for leukoreduction) - Induction chemotherapy- initiated only after leukoreduction, as it carries a high-risk of acute tumor lysis syndrome', 'role': 'assistant'}]