Leukapheresis and low-dose chemotherapy do not reduce early mortality in acute myeloid leukemia hyperleukocytosis: A systematic review and meta-analysis

Oberoi, Sapna; Lehrnbecher, Thomas; Phillips, Bob; Hitzler, Johann; Ethier, Marie‐Chantal; Beyene, Joseph; Sung, Lillian

doi:10.1016/j.leukres.2014.01.004

Cited by 112 publications

(97 citation statements)

References 36 publications

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“…295 Hyperleukocytosis reflects a medical emergency. After immediate diagnostic testing, patients should begin cytoreductive treatment without delay preferably with the planned induction regimen.…”

Section: Management Of Special Situations Hyperleukocytosismentioning

confidence: 99%

Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel

Döhner

Estey

Grimwade

et al. 2017

Blood

4,434

4,950

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The first edition of the European LeukemiaNet (ELN) recommendations for diagnosis and management of acute myeloid leukemia (AML) in adults, published in 2010, has found broad acceptance by physicians and investigators caring for patients with AML. Recent advances, for example, in the discovery of the genomic landscape of the disease, in the development of assays for genetic testing and for detecting minimal residual disease (MRD), as well as in the development of novel antileukemic agents, prompted an international panel to provide updated evidence- and expert opinion-based recommendations. The recommendations include a revised version of the ELN genetic categories, a proposal for a response category based on MRD status, and criteria for progressive disease

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Section: Management Of Special Situations Hyperleukocytosismentioning

confidence: 99%

Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel

Döhner

Estey

Grimwade

et al. 2017

Blood

4,434

4,950

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“…Ранняя леталь-ность выразилась в 5,5% -1 больной умер от инфекцион-ных осложнений в аплазии после индукционного курса ПХТ. Этот показатель значительно ниже данных, приво-димых разными исследователями [28], но значимо не от-личается от тех, что получены при анализе результатов терапии всей популяции больных в условиях ГНЦ Минз-драва России по протоколу ОМЛ-01.10, где процент до-стижения полных ремиссий составляет 85 при минималь-ном проценте ранней летальности -2,9 [19]. Для всех больных ОМЛ 3-летняя общая выживаемость составила 45,6%, безрецидивная -41,5% [19], у больных с ГЛ в де-бюте ОМЛ и та, и другая были равны 50% (рис.…”

Section: терапевтический архив 7 2015unclassified

Treatment in adult patients with acute myeloid leukemias with hyperleukocytosis at disease onset

Troitskaya¹,

Паровичникова²,

Sokolov³

et al. 2015

Ter. arkh.

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“…27 A larger pediatric study reported by the Children's Oncology Group demonstrated no reduction in mortality with leukocytapheresis. 1 Recently, Oberai et al 28 performed a systematic review and meta-analysis evaluating early deaths in patients with AML and WBC Ն100 ϫ 10 9 /L. Twenty-one studies were included, comprising 1500 adult and pediatric patients.…”

Section: Efficacymentioning

confidence: 99%

“…Oberai et al concluded that there is no demonstrated benefit to leukocytapheresis and/or hydroxyurea/low-dose chemotherapy for patients with AML and suggested that they may not have a role at all. 28 According to the 2013 Guidelines on the Use of Therapeutic Apheresis in Clinical Practice published by the American Society for Apheresis (ASFA), hyperleukocytosis secondary to AML and ALL is a category I recommendation for the treatment of leukostasis and a category III recommendation for prophylaxis (Table 1).…”

Section: Efficacymentioning

confidence: 99%

Leukocytapheresis for the treatment of hyperleukocytosis secondary to acute leukemia

Aqui

O’Doherty

2014

Hematology

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Patients presenting with new or recurrent acute leukemia, particularly of the myeloid lineage, with WBC counts exceeding 100 ϫ 10 9 /L are often considered for leukocytapheresis, especially if they are experiencing symptoms of leukostasis. These symptoms are thought to occur because of blast aggregates and WBC thrombi in the circulation, which reduce blood flow. Leukostasis may cause various complications, including hyperviscosity syndrome, vascular occlusion resulting in intracranial hemorrhages and respiratory failure, and perivascular leukemic infiltrates. Leukostasis occurs more commonly with a high WBC count and with leukemias of monocytoid lineage such as acute myelomonocytic leukemia, which is a reflection of the nature of the leukemic blasts. Leukocytapheresis is used in an effort to quickly decrease a patient's circulating blast count, which can both prevent the development of leukostasis and provide symptomatic relief of leukostasis. However, the impact of leukocytapheresis on early-and long-term mortality is controversial, with several studies producing conflicting results. In this chapter, the pathophysiology of leukostasis, performance of leukocytapheresis, and efficacy of this treatment are reviewed. Learning Objective• To gain an understanding of the pathophysiology of leukostasis and the role of leukocytapheresis as a therapeutic invention

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Leukapheresis and low-dose chemotherapy do not reduce early mortality in acute myeloid leukemia hyperleukocytosis: A systematic review and meta-analysis

Cited by 112 publications

References 36 publications

Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel

Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel

Treatment in adult patients with acute myeloid leukemias with hyperleukocytosis at disease onset

Leukocytapheresis for the treatment of hyperleukocytosis secondary to acute leukemia

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