Does anything need to be done if hyperlymphocytosis (i.e. ALC > 300K) develops in a CLL patient just starting ibrutinib?

Leukostasis is a feared complication of acute myeloid leukemia (AML) in patients developing peripheral WBC counts >100,000. The cells in AML are large, sticky, and invasive. By contrast, the lymphocytes in chronic lymphocytic leukemia are small (10 microns or so; not much larger than red blood cells), not sticky but fragile, and are not invasive. Accordingly, CLL blood counts in the hundreds of thousand per microliter are generally not dangerous.

I have heard of patients with cell counts of 200,...