Paraneoplastic Leukemoid Reaction in a Patient with Urothelial Carcinoma: A Case Report
Bibliographic record
Abstract
Introduction: Leukemoid reactions in cancer are rare and associated with a poor prognosis. The mechanism driving paraneoplastic leukemoid reactions appears to be gain-of-function granulocyte-colony stimulating factor (G-CSF) secretion by tumour cells. Case Presentation: A 57-year-old male smoker presented with a one-year history of painless frank hematuria and three kilograms weight loss. Cystoscopy revealed a high-grade urothelial carcinoma with sarcomatoid differentiation. The patient was treated by radical cystoprostatectomy, bilateral pelvic lymph node dissection and formation of an ileal conduit. In the absence of bone marrow infiltrations, recurrence of the urothelial carcinoma three months later was associated with a paraneoplastic leukemoid reaction with a white blood cell count peaking at 82.62 × 109/l. Unfortunately, his condition continued to deteriorate and he died shortly thereafter. Conclusion: Monitoring of white blood cell counts in paraneoplastic leukemoid reactions can be a useful indicator of response of the malignancy to chemotherapy or radiotherapy and an indication of relapse after treatment. Paraneoplastic leukemoid reactions are caused by G-CSF secretion by tumour cells and are associated with a poor prognosis. Whether G-CSF signaling plays a role in the aggressive nature of these cancers is currently unknown.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".