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Hematologic Emergencies

Life-threatening hematologic syndromes requiring rapid intervention

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Hematoloji department. Book Appointment →

What is Hematologic Emergencies?

Hematologic emergencies are life-threatening syndromes that affect blood cells, the coagulation system, or the bone marrow and require urgent intervention. Hyperleukocytosis (WBC above 100,000/mm3), disseminated intravascular coagulation (DIC), tumor lysis syndrome (TLS), thrombotic thrombocytopenic purpura, and massive hemorrhage are leading examples.

In hyperleukocytosis, leukostasis can clog the pulmonary and cerebral microcirculation with leukocyte plugs and requires leukapheresis plus emergent induction chemotherapy. DIC must be managed for both bleeding and thrombotic risk simultaneously. In TLS, hyperuricemia, hyperkalemia, and hyperphosphatemia can drive acute kidney injury.

Massive transfusion (more than 10 red cell units in 24 hours) is often complicated by hypofibrinogenemia and dilutional coagulopathy. The massive transfusion protocol (MTP) should be activated, and fibrinogen replacement, platelet transfusion, and plasma support should be coordinated together.

Symptoms

Severe bleeding or extensive ecchymoses
Dyspnea and hypoxia (leukostasis)
Confusion and other neurologic findings
Oliguria or anuria from acute kidney injury
High fever and rigors
Tachycardia and hypotension

Risk Factors

Diagnosis of acute leukemia, especially AML M3 or ALL
Hematologic malignancies with high tumor burden
Sepsis and multi-organ dysfunction
Patients on therapeutic anticoagulation
Massive surgery or trauma

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Uncontrolled bleeding develops
  • New-onset dyspnea or altered consciousness
  • Rapidly rising white blood cell count in known acute leukemia

Treatment Methods

01
Hyperleukocytosis: leukapheresis, hydroxyurea, induction chemotherapy
02
DIC: treat the underlying cause, heparin or antithrombin in selected cases
03
TLS: hydration, rasburicase, electrolyte correction
04
TTP: urgent plasma exchange and caplacizumab
05
Massive transfusion protocol (RBC:FFP:platelets 1:1:1)
06
Fibrinogen replacement with cryoprecipitate or concentrate

Which Department to Visit?

You can visit our Hematoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Hematoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.