In recent years, lactic acidosis has been recognized in patients with a variety of disease states.1,2 In some patients, there may be an obvious underlying metabolic disorder, usually related to hypoxia. In others, such as those with the idiopathic form of lactic acidosis described by Huckabee,3 there is no known direct cause.
A small proportion of patients with leukemia have lactic acidosis, but there is no clear explanation for this finding.4,5 Some authors have hypothesized that leukemic cells which are "packed" in the marrow become hypoxic, utilize anaerobic metabolic pathways, and overproduce lactate.4 This hypothesis has not been clearly documented, partly because in other reports the association of lactic acidosis and leukemia was obscured by complicating infection or treatment prior to the development of acidosis.
This communication describes a patient who had severe lactic acidosis prior to the diagnosis of acute myeloblastic leukemia. He was relatively