Leukemoid Reactions to Tuberculosis

TUBERCULOSIS has been associated with a variety of hematological abnormalities. These include hypoplasia of the bone marrow,¹,²myelofibrosis,³⁻⁵and polycythemia.⁶Tuberculosis is sometimes associated with a leukemoid reaction which must be differentiated from leukemia. In 1911 Coley and Ewing,⁷from postmortem studies, first drew attention to the leukemoid response which may be evoked by tuberculosis. The association was first made antemortem by Mills and Townsend⁸in 1937. We have found only 38 reports of patients who had leukemoid reactions to tuberculosis which fulfilled the following criteria: (1) tubercle bacilli had to be demonstrated and (2) an excessive leukocytosis or an abnormal shift towards immaturity in the peripheral blood or in the bone marrow. A diagnosis of leukemia was considered to be excluded if a lasting hematologic recovery occurred or if visceral infiltration with leukocytes could not be demonstrated at autopsy. It is the purpose of this paper to discuss