All of the following are true regarding Leukemoid reaction, EXCEPT:
Ans. b (Neutrophil count > or = 11,600/mL) > D (HB > 9 gm%) (Ref. Harrison medicine 16th ed., 353)FeaturesLeukemoid ReactionCML1 WBC10-100 K30-500 K2 Eos/BasRareIncreased3 LAP score>100>104 OrganomegalyAbsentPresentLEUKEMOID REACTION# The term leukemoid reaction is used to describe persistent neutrophilia with cell counts of more than or equal to 30, 000-50, 000/microLiter that is not leukemic in etiology. The circulating neutrophils are usually mature and not clonally derived.# Leukemoid reactions are the response of normal bone marrow to cytokine release by lymphocytes, macrophages, and other cells in response to infection or trauma. In a leukemoid reaction, the circulating neutrophils are usually mature and are not clonally derived.# It is usually seen in response to infection, inflammation, or therapeutic agents such as growth factors and is less commonly caused by malignancy. Milder elevations in leukocyte count are common both in carcinoma and Hodgkin lymphoma. White cell counts in excess of 10000/mL have been found in 14.5% of 227 patients with lung carcinoma and in 27% of 100 patients with Hodgkin disease.# The major differential diagnosis is with regard to CML.# Leukemoid reactions should also be distinguished from leukoerythroblastic reactions: the presence of immature white cells and nucleated red cells in the peripheral blood irrespective of the total leukocyte count. Although less common than leukemoid reactions in adults, leukoerythroblastosis reflects serious marrow stimulation or dysfunction and should prompt bone marrow aspiration and biopsy, unless it occurs in association with severe hemolytic anemia, sepsis in a patient with hyposplenism, or massive trauma. In such patients, trauma, hemorrhage, and infection all will contribute to potent cytokine release and marrow stimulation.# The absence of splenomegaly, leukocyte precursors (myelocytes, metamyelocytes), basophilia, or eosinophilia all point away from CML, and the elevated LAP score confirms the diagnosis of a leukemoid. reaction.Definition of leukemoid is persistent neutrophilia with counts > 50.000. And normal thrombocyte count, normal HB and blast count < 5%.
Blast cells <5%
Neutrophil count > or = 11600/mL
Platelet count 1, 00, 000/mL
Hemoglobin > 9gm%
Blood