Lisa M. Blackburn, MS, RN-BC, AOCNS®, is a clinical nurse specialist, Shelly Brown, MS, RN, AOCNS®, is a leukemia clinical nurse specialist, Aimee Munyon, RN, MS, CNP, is a hematology nurse practitioner, and Michelle Orovets, BSN, RN, OCN®, is an RN, all at the Ohio State University Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in Columbus. Blackburn can be reached at email@example.com, with copy to CJONEditor@ons.org. (Submitted February 2017. Accepted April 16, 2017.)
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Management to prevent crisis in acute leukemiaSymbolBACKGROUND:Hyperleukocytosis, a peripheral white blood cell count greater than 100,000/mm3, is most commonly seen in patients with newly diagnosed or relapsed acute lymphoblastic leukemia and acute myeloid leukemia. Leukostasis is a reduction in blood flow related to hyperviscosity. Hyperleukocytosis, causing leukostasis, is an oncologic emergency and requires an exacting assessment and rapid response with appropriate intervention to prevent morbidity and mortality in the first week after diagnosis.OBJECTIVES:The objectives of this article are to equip oncology nurse to identify patients with hyperleukocytosis and to provide nursing interventions that will ensure safe, quality care.METHODS:A case study is used to demonstrate key concepts that are critical in early assessment, identification, and treatment of patients with leukostasis.FINDINGS:Oncology nurses well versed in the pathophysiology, clinical presentation, and management of leukostasis can make a significant contribution to the safe management of patients with cancer.