Early Mortality of Hyperleukocytosis in Childhood Acute Leukemia
Keywords:
Hyperleukocytosis, early mortality rate, early outcomeAbstract
Background: Acute leukemia with hyperleukocytosis (white blood cells more than 100 x109/L) is associated with high mortality rate in the early phase of treatment.
Objective: This study aimed to determine early mortality rate (within first 14 days after diagnosis), complications during treatment, causes of early death and type of treatment of patients with hyperleukocytosis. This constituted a retrospective study; data were collected from children who received a diagnosis of acute leukemia with hyperleukocytosis at Maharat Nakhon Ratchasima Hospital from January 1st, 2010 to December 31th, 2019.
Results: In all, 64 patients diagnosed as hyperleukocytosis (14.7% of acute leukemia among children). Forty-nine patients (76.5%) had acute lymphoblastic leukemia and 15 patients (23.5%) exhibited acute myeloid leukemia. Tumor lysis syndromes were found in eleven patients (17.1%). Nineteen patients (29.7%) received exchange transfusion and 1 patient (1.6%) received leukapheresis. The early mortality rate was 4.68% (3 patients). All death cases comprised AML and the first white blood cell counts were greater than 300 x109/L. Causes of death were intracerebral hemorrhage and respiratory failure from hyperviscosity syndrome.
Conclusion: AML patients presenting white blood cell counts at first visit more than 300 x109/L had high mortality rate. Therefore, emergency treatment and monitoring intracerebral hemorrhage, were keys to reduce the mortality rate.
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References
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