Leukemoid reaction is usually defined as a nonleukemic WBC count more than 50,000/mm3 (50 х 109/L) or a differential count with more than 5% metamyelocytes or earlier cells. It is basically a more severe or pronounced form of ordinary nonneoplastic granulocyte reaction. Some conditions associated with leukemoid reaction are severe bacterial infections, severe toxic states (burns, tissue necrosis, etc.), extensive bone marrow replacement by tumor, severe hemolytic anemia, severe acute blood loss, and juvenile rheumatoid arthritis.