Relapsed Childhood Acute Myeloid Leukemia: Experience from a Single Tertiary Center in Thailand

Songthawee, Natsaruth; Sripornsawan, Pornpun; Chavananon, Shevachut; McNeil, Edward; Chotsampancharoen, Thirachit

doi:10.31557/apjcp.2022.23.12.4079

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…Our treatment protocols were based on the national protocols according to the subtype of leukemia and risk stratification of the patient at presentation. In 2014, an updated version of the Thai national protocols according to the subtypes of leukemia and risk stratification of patients at presentation was implemented [ 28 , 29 ].…”

Section: Methodsmentioning

confidence: 99%

Hyperleukocytosis in Childhood Acute Leukemia: Early Complications and Survival Outcomes

Kittivisuit,

Jongthitinon,

Sripornsawan

et al. 2023

Cancers

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Hyperleukocytosis and extreme hyperleukocytosis, defined as initial white blood cell counts greater than 100 × 109/L and 200 × 109/L, respectively, have been associated with unfavorable outcomes. This study aimed to determine the early complications and survival outcomes of childhood leukemia patients with hyperleukocytosis. The medical records of 690 children newly diagnosed with acute leukemia between January 1998 and December 2017 were retrospectively reviewed. The Kaplan–Meier method and log-rank test were used to assess and compare the survival outcomes. Multivariate Cox proportional hazards regression was used to determine associated risk factors for overall survival. We found that 16.6% of 483 childhood acute lymphoblastic leukemia (ALL) patients and 20.3% of 207 childhood acute myeloid leukemia (AML) patients had hyperleukocytosis at diagnosis. ALL patients with hyperleukocytosis had more early complications than those without hyperleukocytosis (p < 0.05). Among the ALL group, the 5-year overall survival rate for those with hyperleukocytosis was significantly lower than for those without hyperleukocytosis (37.2% vs. 67.8%, p < 0.0001), while the difference was not statistically significant in the AML group (19.0% vs. 30.2%, respectively, p = 0.26). Hyperleukocytosis (hazard ratio [HR]: 2.04), extreme hyperleukocytosis (HR: 2.71), age less than 1 year (HR: 3.05), age greater than 10 years (HR: 1.64), and male sex (HR: 1.37) were independently associated with poorer overall survival in childhood ALL patients. Extreme hyperleukocytosis (HR: 2.63) and age less than 1 year (HR: 1.82) were independently associated with poorer overall survival in AML patients. Hyperleukocytosis was associated with adverse survival outcomes in childhood leukemia.

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Section: Methodsmentioning

confidence: 99%