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Volume 353:1862 October 27, 2005 Number 17
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Diagnosis from the Blood Smear

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by Bain, B. J.
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To the Editor: In her review article (Aug. 4 issue), Bain highlighted the usefulness of examining a blood smear in certain clinical settings.1 We would like to add information on the differential diagnosis of leukocytosis in patients with solid tumors that has potential therapeutic implications. Apart from such common complications as infection or regeneration after chemoradiotherapy, marked neutrophilic leukocytosis with or without left shift can be seen in such patients. These leukemoid reactions sometimes result in a white-cell count of 100,000 per cubic millimeter and resemble myeloproliferative disorders. However, they are reactive in origin, often indicating widespread neoplastic disease.2 Leukemoid . . . [Full Text of this Article]



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