Minimally early morbidity in children with acute myeloid leukemia and hyperleukocytosis treated with prompt chemotherapy without leukapheresis.

Abstract

BACKGROUND/PURPOSE:

Patients with acute myeloid leukemia (AML) and hyperleukocytosis, defined as an initial white blood cell (WBC) count of ≥ 100 × 10(9)/L, are often treated with leukapheresis. In this study, we have reported our experience of treating AML without leukapheresis.

METHODS:

From November 1, 1995, to May 31, 2012, there were 74 children (≤18 years old) with de novo AML other than acute promyelocytic leukemia. Seventeen patients had an initial WBC count ≥ 100 × 10(9)/L. Prompt chemotherapy was started within hours whereas leukapheresis was not performed.

RESULTS:

The median age of the 17 patients with hyperleukocytosis was 7.4 years (range: 0-16 years), and the median initial WBC count was 177 × 10(9)/L (range: 117-635 × 10(9)/L). The median time between admission and initiation of chemotherapy was 4.5 hours (range: 2-72 hours) in patients with hyperleukocytosis, whereas it was 13 hours (range: 2-120 hours) in those without hyperleukocytosis. Seven patients (7/17, 41%) had one or more early complications before or during the first 2 weeks of chemotherapy. Fifteen of the 16 patients who received prompt chemotherapy achieved complete remission (93.8%), comparable with those without hyperleukocytosis (98.2%; p = 0.33).

CONCLUSION:

Children with AML and hyperleukocytosis, treated with prompt chemotherapy without leukapheresis, had minimal early morbidities.

• Authors: Kuan-Hao Chen, Hsi-Che Liu, Der-Cherng Liang, Jen-Yin Hou, Ting-Huan Huang, Ching-Yi Chang, Ting-Chi Yeh
• Journal: Journal of the Formosan Medical Association = Taiwan yi zhi (J Formos Med Assoc) Vol. 113 Issue 11 Pg. 833-8 (Nov 2014) ISSN: 0929-6646 [Print] Singapore
• PMID: 24534017 (Publication Type: Journal Article)
• Copyright: Copyright © 2014. Published by Elsevier B.V.

Chemical References

• Antineoplastic Agents

Topics

• Adolescent
• Antineoplastic Agents (therapeutic use)
• Child
• Child, Preschool
• Female
• Humans
• Infant
• Infant, Newborn
• Leukapheresis
• Leukemia, Myeloid, Acute (drug therapy)
• Leukocyte Count
• Leukocytosis (drug therapy)
• Male
• Morbidity
• Prospective Studies
• Remission Induction
• Treatment Outcome