Outcome of hyperleukocytic adult acute myeloid leukaemia: A single-center retrospective study and review of literature

Marbello, Laura; Ricci, Francesca; Nosari, Anna Maria; Turrini, Mauro; Nador, Guido; Nichelatti, Michele; Tedeschi, Alessandra; Vismara, Eleonora; Morra, Enrica

doi:10.1016/j.leukres.2008.01.004

Cited by 80 publications

(55 citation statements)

References 29 publications

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“…The prognostic significance of leukocytosis remains ambiguous (with the exception of hyperleukocytosis of over 100 x 10 9 /l) [14]. The results of various studies (focused on initial leukocyte count and its prognostic significance) are not uniform.…”

Section: Discussionmentioning

confidence: 99%

Secondary acute myeloid leukemia – a single center experience

Szotkowski¹,

Rosenberger²,

Zapletalova³

et al. 2010

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Secondary acute myeloid leukemia (sAML) may arise from the previous clonal disorder of hematopoiesis, usually from myelodysplastic syndrome (MDS) or from chronic myeloproliferative neoplasia (cMPN) or after exposure to a leukemogenic agent (previous chemotherapy or radiotherapy, some immunosuppressive drugs or environmental leukemogenic agents). Secondary origin of AML is associated with unfavorable prognosis and it is not considered to be conventionally curable (with the exception of secondary acute promyelocytic leukemia).The presented study is a retrospective analysis of patients diagnosed and treated at the Department of Hemato-Oncology, University Hospital Olomouc in 1996-2008. Over that period of time, a total 574 patients with AML were diagnosed. Of those, 430 patients were diagnosed as having primary AML; in 86 patients, sAML transformed from myelodysplastic syndrome and 58 patients were followed or treated for various malignancies or were treated with potentially leukemogenic agents because of non-malignant disorders.Patients with secondary AML are older and less commonly treated with curative intention than those with primary AML. According to cytogenetic findings, their prognosis is often worse. Complete hematologic remission is achieved with a low probability, relapse of the disease occurs frequently and overall survival is worse in almost all prognostic subgroups. With the exception of secondary acute promyelocytic leukemia, the prognosis of which does not differ from very good prognosis of the primary forms, secondary AML is not considered a conventionally curable disease.

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Section: Discussionmentioning

confidence: 99%

Secondary acute myeloid leukemia – a single center experience

Szotkowski¹,

Rosenberger²,

Zapletalova³

et al. 2010

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“…Firstly, patients with APL in whom WBC count at diagnosis is part of a scoring system assessing the risks of both early mortality and relapse (30). Secondly, patients with hyperleukocytosis (>100x10 9 /L), have a higher risk of early death, leukostasis, tumor lysis syndrome, infection and the leukemic CNS involvement (31)(32)(33)(34)(35). The results of the other analyses of the prognostic value of the initial WBC count in AML patients are inconsistent.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors and treatment outcome in 1,516 adult patients with de novo and secondary acute myeloid leukemia in 1999–2009 in 5 hematology intensive care centers in the Czech Republic

Szotkowski

Mužík²,

Voglová³

et al. 2010

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Acute myeloid leukemia (AML) is a severe condition with a high mortality. When making decisions about the optimal tailor-made therapy, numerous prognostic factors are considered. The study represents a detailed analysis of the role of these factors and treatment outcomes based on a long-term follow-up of patients treated in 5 hematology intensive care centers in the Czech Republic.The studied group comprised 1,188 patients with de novo AML and 328 patients with secondary AML. The latter were significantly older, had more unfavorable cytogenetic changes and less frequently received curative therapy. Curatively treated patients achieved fewer complete remissions and relapsed more often than those with de novo AML. Patients with secondary AML had lower rates of allogeneic transplantation as part of consolidation therapy and a significantly shorter median overall survival. A lower proportion of the patients were alive at the time of analysis.However, the treatment outcome of de novo AML patients is not satisfactory, the only exception being those with acute promyelocytic leukemia. The analysis, which did not evaluate the intention-to-treat criteria and was without randomization, found allogeneic stem cell transplantation to be the most effective modality of consolidation therapy in both groups of patients.

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“…: +7(495)612-4592; e-mail: verat@blood.ru Гиперлейкоцитоз (ГЛ), под которым понимают коли-чество лейкоцитов более 100·10 9 /л в периферической кро-ви, является прогностически неблагоприятным фактором при целом ряде вариантов острых лейкозов (ОЛ). ГЛ диа-гностируют при остром миелоидном лейкозе (ОМЛ) у взрослых в 5-13% случаев, у детей -в 12-25%, при остром лимфобластном лейкозе (ОЛЛ) -в 10-30% [1,2]. Ведение такого больного по-прежнему является крайне сложным как для онкогематолога и клинического транс-фузиолога, так зачастую и для реаниматолога.…”

Section: терапевтический архив 7 2015unclassified

“…1). По данным литературы [1,2], до 90% случаев в структу-ре ранней летальности при ОМЛ (в 1-ю неделю терапии) приходится на ГЛ. Основными причинами этого считают-ся возникающий на фоне индукционной терапии синдром массивного опухолевого распада, а также лейкостазы, обу-словливающие развитие неврологических нарушений, ре-спираторного дистресс-синдрома на фоне поражения лег-ких, ДВС-синдрома с развитием жизнеугрожающих крово-течений.…”

Section: терапевтический архив 7 2015unclassified

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