• Kuan-Hao Chen, Hsi-Che Liu, Der-Cherng Liang, Jen-Yin Hou, Ting-Huan Huang, Ching-Yi Chang, and Ting-Chi Yeh.
• Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Division of Pediatric Hematology-Oncology, Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
• J Formos Med Assoc. 2014 Nov 1; 113 (11): 833-8.

Background/PurposePatients 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.MethodsFrom 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.ResultsThe 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).ConclusionChildren with AML and hyperleukocytosis, treated with prompt chemotherapy without leukapheresis, had minimal early morbidities.Copyright © 2014. Published by Elsevier B.V.

25 keywords...

hide…