Management of hyperleukocytosis and impact of leukapheresis among patients with acute myeloid leukemia (AML) on short- and long-term clinical outcomes: a large, retrospective, multicenter, international study.

Leukemia
Maximilian StahlAmer M Zeidan

Abstract

Hyperleukocytosis in acute myeloid leukemia (AML) is associated with inferior outcomes. There is limited high quality evidence to support the benefits of leukapheresis. We retrospectively collected data from patients with newly-diagnosed AML who presented with a white cell count (WBC) >50 × 109/L to 12 centers in the United States and Europe from 2006 to 2017 and received intensive chemotherapy. Logistic regression models estimated odds ratios for 30-day mortality and achievement of composite complete remission (CRc). Cox proportional hazard models estimated hazard ratios for overall survival (OS). Among 779 patients, clinical leukostasis was reported in 27%, and leukapheresis was used in 113 patients (15%). Thirty-day mortality was 16.7% (95% CI: 13.9-19.3%). Median OS was 12.6 months (95% CI: 11.5-14.9) among all patients, and 4.5 months (95% CI: 2.7-7.1) among those ≥65 years. Use of leukapheresis did not significantly impact 30-day mortality, achievement of CRc, or OS in multivariate analysis based on available data or in analysis based on multiple imputation. Among patients with investigator-adjudicated clinical leukostasis, there were statistically significant improvements in 30-day mortality and OS with leukapheresis in ...Continue Reading

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Citations

Jan 7, 2021·Journal of the National Comprehensive Cancer Network : JNCCN·Daniel A PollyeaMartin S Tallman
Nov 25, 2020·Pediatric Clinics of North America·Lama ElbahlawanRaul C Ribeiro
Mar 21, 2021·Scientific Reports·Howon LeeYonggoo Kim
Mar 10, 2021·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Mesut Göçer, Erdal Kurtoğlu
Jul 22, 2021·International Journal of General Medicine·Dongdong ZhangYouhong Dong
Sep 15, 2021·Intensive Care Medicine·Élie AzoulayÉtienne Lengliné

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Methods Mentioned

BETA
leukapheresis
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