Journal of Pediatric Critical Care · Published 2025-11-01 · DOI 10.4103/jpcc.jpcc_135_25
Hyperleukocytosis and thrombocytosis represent critical hematological emergencies frequently encountered in pediatric intensive care units. Hyperleukocytosis, defined as a white blood cell count exceeding 100,000/μL, occurs predominantly in acute lymphoblastic leukemia and acute myeloid leukemia (AML), with the potential for life-threatening complications including leukocytosis, tumor lysis syndrome (TLS), and coagulopathy. Thrombocytosis, characterized by platelet counts above 450,000/μL, is predominantly reactive in children but can present as extreme thrombocytosis (>1,000,000/μL) with paradoxical thrombotic and hemorrhagic risks. Early recognition, risk stratification, and coordinated multidisciplinary intervention are paramount. This comprehensive review synthesizes current evidence on pathophysiology, clinical manifestations, diagnostic approaches, and evidence-based management strategies for both conditions. Understanding the nuances of these conditions and implementing timely, evidence-based interventions significantly reduces early mortality and improves long-term outcomes in critically ill children.
Abstract from DOAJ. Public domain (CC0 1.0).
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