In:
European Journal of Haematology, Wiley, Vol. 101, No. 1 ( 2018-07), p. 86-94
Abstract:
Acute myeloid leukemia ( AML ) with hyperleukocytosis ( HL ) is intuitively thought as a unique group with dismal prognosis. However, comprehensive studies regarding the genetic landscape and clinical outcome in this group of patients are limited. Methods A total of 693 newly diagnosed de novo non‐M3 AML patients were consecutively enrolled. We compared relevant mutations in 20 genes between AML patients with or without HL and exposed their prognostic implications. Results Hyperleukocytosis, defined as initial white blood cell counts above 50 000/μL, occurred in 28.9% of AML patients. HL patients had higher incidences of FLT 3‐ ITD , NPM 1 , DNMT 3A , CEBPA , and TET 2 mutations. Multivariate analysis demonstrated that HL was an independent poor prognostic factor for overall survival and disease‐free survival in total patients, those with intermediate‐risk cytogenetics and normal karyotype irrespective of genetic alterations. Intriguingly, HL predicted poor survival in CEBPA double mutated, NPM 1 + / FLT 3 ‐ ITD ‐ and NPM 1 ‐/ FLT 3 ‐ ITD ‐ patients. Further, HL patients who received allogeneic hematopoietic stem cell transplantation (allo‐ HSCT ) in first complete remission ( CR ) had a significantly longer overall survival and disease‐free survival than those without allo‐ HSCT . Conclusions Hyperleukocytosis is an independent poor prognostic factor irrespective of cytogenetics and mutation status. Allo‐ HSCT in first CR seems to ameliorate the poor prognostic impact of HL .
Type of Medium:
Online Resource
ISSN:
0902-4441
,
1600-0609
DOI:
10.1111/ejh.2018.101.issue-1
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2027114-1
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