Gustave Roussy Institute Of Cancerologie

Villejuif, France

Gustave Roussy Institute Of Cancerologie

Villejuif, France
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Canaani J.,Tel Aviv University | Labopin M.,French Institute of Health and Medical Research | Labopin M.,University Pierre and Marie Curie | Socie G.,French Institute of Health and Medical Research | And 12 more authors.
American Journal of Hematology | Year: 2017

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. © 2017 Wiley Periodicals, Inc.

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