Impact Of ELN Risk Stratification, Induction Chemotherapy Regimens And Hematopoietic Stem Cell Transplantation On Outcomes In Hyperleukocytic Acute Myeloid Leukemia With Initial White Blood Cell Count More Than 100 × 109/L
| Autor: | Li Zhou, Xiaoyu Zhu, Changcheng Zheng, Baolin Tang, Xinhui Zhang, Zimin Sun, Huilan Liu, Shanglong Feng |
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| Rok vydání: | 2019 |
| Předmět: |
hyperleukocytosis
0301 basic medicine medicine.medical_specialty medicine.medical_treatment Hematopoietic stem cell transplantation acute myeloid leukemia Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine CEBPA Medicine Risk factor ELN risk stratification induction chemotherapy Original Research business.industry Induction chemotherapy Leukostasis medicine.disease Transplantation Tumor lysis syndrome Regimen 030104 developmental biology Oncology Cancer Management and Research 030220 oncology & carcinogenesis hematopoietic stem cell transplantation business |
| Zdroj: | Cancer Management and Research |
| ISSN: | 1179-1322 |
| DOI: | 10.2147/cmar.s225123 |
| Popis: | Shanglong Feng,1,* Li Zhou,2,* Xinhui Zhang,1,* Baolin Tang,2 Xiaoyu Zhu,2 Huilan Liu,2 Zimin Sun,2 Changcheng Zheng1,2 1Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, People’s Republic of China; 2Department of Hematology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Changcheng ZhengDepartment of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, People’s Republic of ChinaTel/fax +86-551-62284476Email zhengchch1123@ustc.edu.cnBackground: Hyperleukocytic acute myeloid leukemia (AML) (initial white blood cell count≥100 × 109/L) is a clinical emergency often accompanied by leukostasis syndrome, tumor lysis syndrome (TLS), and disseminated intravascular coagulation (DIC), with a poor clinical prognosis. The aim of this study retrospectively analyzed the clinical features of hyperleukocytic AML, focusing on high-risk factors affecting prognosis, the selection of initial induction therapy, and the impact of hematopoietic stem cell transplantation (HSCT) on prognosis.Patients and methods: A total of 558 AML patients at our center from January 2013 to December 2017 were diagnosed, and 52 (9.32%) patients presented with hyperleukocytosis were retrospectively reviewed.Results: The 3-year overall survival (OS) rate in the 15–39 years old and 40–60 years old group was 58.8% and 25.4%, respectively; the longest survival time in patients aged >60 years was only 8 months, and the 8-month OS rate was 8.3% (p=0.002). The 3-year OS rate of the patients in the favorable risk group, intermediate risk group and high risk group, according to the 2017 ELN risk stratification, was 50%, 28.0%, and 29.5%, respectively (p=0.374). The 3-year OS rate of patients carrying CEBPA or NPM1 mutation and those with FLT3-ITD or MLL mutation was 37.5% and 30.0%, respectively (p=0.63). The 3-year OS rate of patients employing an induction regimen of a standard IA regimen was 58.4%, and of those employing a non-standard IA regimen was 22.2% (p=0.065). The 3-year OS rate of the transplantation patients reached 73.8%, while the 9-month OS rate of patients without transplantation was 11.4% (p |
| Databáze: | OpenAIRE |
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