White blood counts exceeding 100 x 10^9 / L (100,000 / microL) present symptoms of tissue hypoxia and may signal possible neurological and respiratory distress. Ongoing research has shown that patients have suffered from hypoxia at leukocyte levels below 100 x 10^9 / L (100,000 / microL), therefore patients with leukemia need regular neurological and respiratory monitoring when leukocyte counts are approaching 100 x 10^9 / L (100,000 / microL) to decrease chances of tissue hypoxia. 811px Acquired biopsies are examined for damage to microvasculature, which serves as evidence of hypoxia through the identification of leukocyte blockage within the tissue. Due to the biopsy's invasive nature and the risks associated with the procedure, it is only used when deemed necessary. Measurements for arterial pO2 have shown to be falsely decreased in patients with hyperleukocytosis because of white blood cells ability to utilize oxygen. Pulse oximetry should be used to more accurately assess pO2 levels of a patient suspected to be suffering from leukocytosis. Automated blood cell counters may be inaccurate due to fragments of blast cells being labeled on blood smears as platelets. The most accurate form of confirming platelet counts is by using a manual platelet count and a review of a peripheral smear. Serum potassium levels may also be artificially elevated by a release from leukemic blasts during in vitro clotting process, therefore serum potassium levels should be monitored by heparinized (the addition of heparin prevents coagulation) plasma samples in order to obtain accurate results of potassium levels. Disseminated intravascular coagulation may occur in a significant number of patients with presentation of various degrees of thrombin generation, followed by decreased fibrinogen and increased fibrinolysis. Spontaneous tumor lysis syndrome is present in approximately 10 percent of patients with<unk> . Lab tests are used to measure the potential of elevated serum concentrations such as uric acid, potassium, phosphate, and hypocalcemia. Disseminated intravascular coagulation and spontaneous tumor lysis syndrome can develop before and after chemotherapy treatment. Patients undergoing this type of therapy need to be closely monitored before and after, in addition to undergoing prophylactic measures to prevent possible complications.
Leukostasis
Vasospasm
Leukocytosis
Thrombocytopenia
Allostasis
Cytotoxicity
Cytopenia
Lipotoxicity