From the Guidelines
Chemotherapy can indeed cause leukocytosis in certain situations, and it is crucial to monitor white blood cell counts regularly in patients undergoing chemotherapy. Leukocytosis is an increase in the number of white blood cells (leukocytes) in the blood, which can occur due to various factors related to chemotherapy. According to the evidence provided by 1 and 1, patients with excessive leukocytosis at presentation may require emergency leukapheresis prior to induction chemotherapy, highlighting the potential for chemotherapy to exacerbate leukocytosis.
Some key factors that can contribute to leukocytosis in patients undergoing chemotherapy include:
- Corticosteroid use: Many chemotherapy regimens include corticosteroids like prednisone or dexamethasone, which can cause a temporary increase in white blood cell count.
- Growth factor administration: Drugs like filgrastim (Neupogen) or pegfilgrastim (Neulasta), often given to prevent neutropenia during chemotherapy, can cause leukocytosis as they stimulate white blood cell production.
- Tumor lysis syndrome: Rapid destruction of cancer cells by chemotherapy can release their contents into the bloodstream, triggering an inflammatory response that increases white blood cell count.
- Rebound effect: After the initial suppression of bone marrow by chemotherapy, there can be a rebound overproduction of white blood cells as the bone marrow recovers.
- Certain chemotherapy drugs: Some agents, like high-dose methotrexate, can occasionally cause leukocytosis.
It is essential to note that while leukocytosis can be a temporary and expected effect of chemotherapy, persistent or extreme elevations should be evaluated by an oncologist to rule out other causes or complications, as recommended by 1. Regular blood tests to monitor white blood cell counts are vital in patients undergoing chemotherapy to ensure prompt identification and management of any potential issues.
From the Research
Chemotherapy and Leukocytosis
- Chemotherapy is not typically associated with causing leukocytosis, but rather, it is often used to treat conditions that cause leukocytosis, such as leukemia 2, 3, 4.
- Leukocytosis is a condition characterized by an elevated white blood cell count, and it can be a symptom of various underlying conditions, including cancer 5, 6.
- In some cases, chemotherapy can cause a temporary increase in white blood cell count, but this is not the same as leukocytosis, which is a more persistent and significant elevation of white blood cells 5.
Relationship between Chemotherapy and Leukocytosis
- Some studies suggest that leukocytosis can be a prognostic factor for cancer patients, and that it may be associated with a poorer outcome 5, 6.
- Chemotherapy can be used to reduce the white blood cell count in patients with leukocytosis, but the effectiveness of this approach can vary depending on the underlying condition and the specific chemotherapy regimen used 2, 3, 4.
- The relationship between chemotherapy and leukocytosis is complex, and more research is needed to fully understand the mechanisms involved and the optimal treatment approaches 5, 6.
Treatment of Leukocytosis
- Leukapheresis, which is a procedure that removes excess white blood cells from the blood, can be used to treat leukocytosis in some cases 2, 3, 4.
- Chemotherapy, such as hydroxyurea or low-dose chemotherapy, can also be used to reduce the white blood cell count in patients with leukocytosis 2, 3, 4.
- The choice of treatment for leukocytosis depends on the underlying condition, the severity of the leukocytosis, and the patient's overall health status 2, 3, 4.