Emergency Cranial Irradiation Effects in Adult Leukemia with Extremely High Leukocytosis

We have treated adult acute leukemia 64 patients between January 1990 and October 1991 at the Chungnam National University Hospital. They were examined for the impact of presenting WBC count on the initial course and from them we have chosen twenty patients whose leukocyte count is over one hundred thousands per cubic millimeter. We divided the twenty patients into 4 groups on the base of treatment modalities: conservative therapy only, chemotherapy only, cranial irradiation only, and chemotherapy with cranial irradiation. Early sudden death rate is lower in cranial irradiation with/without chemotherapy groups than the conservative only or chemotherapy only patients. Also the remission rate is high in cranial irradiation with chemotherapy patients. Therefore we suggest that the rapid intervention of cranial irradiation in adult acute leukemia could be helpful in reducing the early sudden death rate and perhaps in increasing the remission rate