ecancermedicalscience

Review

Leukaemia-associated priapism in children (LAPC): reviewing clinical outcomes and management strategies

27 Feb 2025
Abhijit Shah, Surag KR, Anupam Choudhary, Kasi Viswanath, Krishnakanth AVB, Chaitanya Krishna, Padmaraj Hegde, Gayathri S, Swathi PM

Background: Priapism is a prolonged penile erection for more than 4 hours unrelated to sexual stimulation. Rarely, it is the first clinical sign of an underlying haematological malignancy. A similar presentation is noted in childhood leukaemias. Although rare, it is known to occur and, if not managed early, can have poor long-term outcomes in terms of erectile function and psychosexual growth. We present a scoping review of leukaemia-associated priapism in children (LAPC).

Methodology: We researched literature using PubMed, Google Scholar, Embase, Scopus and Cochrane databases from January 1990 to 2024. Applicable search limiters were applied, and grey literature was excluded.

Results: A total of 31 articles were finally included in the review, from which 51 cases of LAPC were isolated and studied. The average age was 11.5 years, with chronic myeloid leukaemia (CML) being the most common malignancy (68.9%), and more than 71% of cases of CML with priapism were detected in the chronic phase. Twenty cases (39.2%) were managed with corporal lavage and sympathomimetic injections at the initial onset, with the rest managed with cytoreductive measures initially. Follow-up data revealed the death of three children, whereas, of those that survived, fourteen had preserved erectile functions after a variable period of time.

Conclusion: Priapism in children warrants a thorough physical examination focusing on organomegaly and a complete hemogram. Initial management should be two-pronged with a priapism-directed corporal-lavage approach and cytoreductive measures for better long-term outcomes.

Related Articles

Lisa Ximena Rodríguez Rojas, Liliana Doza Martínez, Jorge Andrés Olave Rodríguez, Sandra Eliana Murillo Rusynke, Paola Andrea Pérez Castellano, David Alexander Bolaños Beltrán, Helen Johana Ortiz Rojas, José Antonio Nastasi Catanese
Priti Singh, Chaithanya Leon, Simran Kaur, Atul Batra, Prashant Tayade, Muthukrishnan Suriya Prakash, Ratna Sharma
Ximena Mimica, Loreto Fernández González, Jorge Sapunar, Felipe Contreras, Matías Lavín, Gustavo Vial O, Gustavo Vial C, Daniel Ledezma, Luis Marín, David Cohn
Arunah Chandran, Ishu Kataria, Kunal Oswal, Rita Isaac, Meritxell Mallafré-Larrosa, Sathishrajaa Palaniraja, Rajaraman Swaminathan, Rohit Rebello, Nandimandalam Venkata Vani, Bindhya Vijayan, Moni Kuriakose, Arnie Purushotham, Rengaswamy Sankaranarayanan, Jerard Selvam, Richard Sullivan, Partha Basu