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Acute Leukemias - Republican Scientific Medical Library

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286 Chapter 23 · Emergencies in <strong>Acute</strong> Lymphoblastic Leukemia<br />

receive a total radiation dose of 3000 cGy, with 1000–<br />

1,500 cGy of it applied to the nerve sheath and the cranial<br />

base [80].<br />

23.10 Other Organ Involvement<br />

Leukemic cells may infiltrate virtually any organ system,<br />

especially in mature B-cell ALL (32%) and T-cell<br />

ALL, and usually do not cause significant morbidity.<br />

However, patients presenting with diffuse abdominal<br />

pain require immediate evaluation by the surgeon,<br />

due to high mortality rate (100%) from bowel perforation<br />

attributable to leukemic infiltrates [81]. Cases of<br />

splenic rupture form leukemic infiltrate and priapism<br />

due to leukostasis in corpora cavernosa and dorsal<br />

vein and sacral involvement in ALL have been described<br />

[82, 83].<br />

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