Long term impact of hyperleukocytosis in newly diagnosed acute myeloid leukemia patients undergoing allogeneic stem cell transplantation: An analysis from the acute leukemia working party of the EBMT. Academic Article uri icon

Overview

abstract

  • Up to 20% of acute myeloid leukemia (AML) patients present initially with hyperleukocytosis, placing them at increased risk for early mortality during induction. Yet, it is unknown whether hyperleukocytosis still retains prognostic value for AML patients undergoing hematopoietic stem cell transplantation (HSCT). Furthermore, it is unknown whether hyperleukocytosis holds prognostic significance when modern molecular markers such as FLT3-ITD and NPM1 are accounted for. To determine whether hyperleukocytosis is an independent prognostic factor influencing outcome in transplanted AML patients we performed a retrospective analysis using the registry of the acute leukemia working party of the European Society of Blood and Marrow Transplantation. A cohort of 357 patients with hyperleukocytosis (159 patients with white blood count [WBC] 50 K-100 K, 198 patients with WBC ≥ 100 K) was compared to 918 patients without hyperleukocytosis. Patients with hyperleukocytosis were younger, had an increased rate of favorable risk cytogenetics, and more likely to be FLT3 and NPM1 mutated. In multivariate analysis, hyperleukocytosis was independently associated with increased relapse incidence (hazard ratio [HR] of 1.55, 95% confidence interval [CI], 1.14-2.12; P = .004), decreased leukemia-free survival (HR of 1.38, 95% CI, 1.07-1.78; P = .013), and inferior overall survival (HR of 1.4, 95% CI, 1.07-1.84; P = .013). Hyperleukocytosis retains a significant prognostic role for AML patients undergoing HSCT.

authors

  • Canaani, Jonathan
  • Labopin, Myriam
  • Socié, Gerard
  • Nihtinen, Anne
  • Huynh, Anne
  • Cornelissen, Jan
  • Deconinck, Eric
  • Gedde-Dahl, Tobias
  • Forcade, Edouard
  • Chevallier, Patrice
  • Bourhis, Jean H
  • Blaise, Didier
  • Mohty, Mohamad
  • Nagler, Arnon

publication date

  • May 26, 2017

Research

keywords

  • Hematopoietic Stem Cell Transplantation
  • Leukemia, Myeloid, Acute
  • Leukocyte Count
  • Leukocytosis

Identity

Scopus Document Identifier

  • 85019742634

Digital Object Identifier (DOI)

  • 10.1002/ajh.24737

PubMed ID

  • 28370339

Additional Document Info

volume

  • 92

issue

  • 7