Lichtman M A, Rowe J M
Blood. 1982 Aug;60(2):279-83.
A small proportion of patients with acute or chronic leukemia has an extraordinarily high blood leukocyte count. These high counts can result in a very high fractional volume of leukocytes (leukocrit), which is also a function of the mean leukocyte volume in different types of leukemia. Despite a high fractional volume of leukocytes, bulk viscosity of blood is usually not increased because a decrement in the fractional volume of erythrocytes accompanies the increase in leukocytes. Nevertheless, the excessive numbers of leukocytes present two major problems: first, they can seriously affect flow in the circulation of the lung, brain, and less often, other organs by obstructing microchannels or by forming aggregates and white thrombi in small veins. Moreover, leukemic blasts may compete for oxygen in the microcirculation and they may be invasive, damaging vessel walls. Second, their rapid destruction in response to cytotoxic drugs causes metabolic disturbances, especially uric acid accumulation, which can lead to obstructive uropathy.
一小部分急性或慢性白血病患者的血液白细胞计数异常高。这些高计数会导致白细胞的分数体积非常高（白细胞压积），这也是不同类型白血病中平均白细胞体积的一个函数。尽管白细胞的分数体积很高，但血液的体积黏度通常不会增加，因为红细胞分数体积的减少伴随着白细胞的增加。然而，过多的白细胞存在两个主要问题：第一，它们会阻塞微通道或在小静脉中形成聚集体和白色血栓，从而严重影响肺、脑以及较少情况下其他器官的血液循环。此外，白血病原始细胞可能在微循环中争夺氧气，并且它们可能具有侵袭性，损害血管壁。第二，它们对细胞毒性药物的快速破坏会导致代谢紊乱，尤其是尿酸积累，这可能导致梗阻性肾病。
