Abstract
A 13-year-old girl with T cell ALL with hyperleukocytosis, tumor lysis syndrome, intracranial hemorrhage, and diabetes mellitus was reported. She presented anemia, bleeding tendency, hepatosplenomegaly, and lymphadenopathy. The white blood cell count was 730, 000/μl with 90% leukemic cells. The bone marrow contained 95% leukemic cells which were considered to be T cell ALL morphologically, cytochemically, and immunologically. Serum creatinine was 5.8 mg/dl and uric acid 17 mg/dl. Leukapheresis was performed three times during the chemotherapy (HEX, TCLSG-11-protocol). First leukapheresis lowered the blood viscosity from 9.72 to 6.06 and the white blood cell count from 770, 000 to 640, 000/μl. Insulin in therapy was initiated because of diabetes mellitus induced by prednisolone and L-asparaginase. Intracranial hemorrhage was judged by computed tomography without neurologic symptoms. Although she achieved a complete remission, she died of pneumonia and leukemic relapse, 13 months after diagnosis.
