Granulocytosis Approximately 30% of patients with solid tumors have granulocytosis (granulocyte count 8000/µL). In about half of patients with granulocytosis and cancer, the granulocytosis has an identifiable nonparaneoplastic etiology (infection, tumor necrosis, glucocorticoid administration, etc.). The other patients have proteins in urine and serum that stimulate the growth of bone marrow cells. Tumors and tumor cell lines from patients with lung, ovarian, and bladder cancers have been documented to produce granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), and/or interleukin 6 (IL-6). However, the etiology of granulocytosis has not been characterized in most patients. . | Chapter 096. Paraneoplastic Syndromes Endocrinologic Hematologic Part 8 Granulocytosis Approximately 30 of patients with solid tumors have granulocytosis granulocyte count 8000 pL . In about half of patients with granulocytosis and cancer the granulocytosis has an identifiable nonparaneoplastic etiology infection tumor necrosis glucocorticoid administration etc. . The other patients have proteins in urine and serum that stimulate the growth of bone marrow cells. Tumors and tumor cell lines from patients with lung ovarian and bladder cancers have been documented to produce granulocyte colony-stimulating factor G-CSF granulocyte-macrophage colony-stimulating factor GM-CSF and or interleukin 6 IL-6 . However the etiology of granulocytosis has not been characterized in most patients. Patients with granulocytosis are nearly all asymptomatic and the differential white blood cell count does not have a shift to immature forms of neutrophils. Granulocytosis occurs in 40 of patients with lung and gastrointestinal cancers 20 of patients with breast cancer 30 of patients with brain tumors and ovarian cancers 20 of patients with Hodgkin s disease and 10 of patients with renal cell carcinoma. Patients with advanced-stage disease are more likely to have granulocytosis than those with early-stage disease. Paraneoplastic granulocytosis does not require treatment. The granulocytosis resolves when the underlying cancer is treated. Thrombocytosis Some 35 of patients with thrombocytosis platelet count 400 000 pL have an underlying diagnosis of cancer. IL-6 a candidate molecule for the etiology of paraneoplastic thrombocytosis stimulates the production of platelets in vitro and in vivo. Some patients with cancer and thrombocytosis have elevated levels of IL-6 in plasma. Another candidate molecule is thrombopoietin a peptide hormone that stimulates megakaryocyte proliferation and platelet production. The etiology of thrombocytosis has not been established in most cases. Patients with .
