Survival analysis of childhood acute leukemia with hyperleukocytosis

Abstract

Background: Hyperleukocytosis was defined as a white blood cell count more than 100 x 109/L. Patients with acute leukemia and hyperleukocytosis have poor prognosis. Objective: This study aimed to determine survival rate, relapse rate and causes of death among patients who were diagnosed with acute leukemia and presented  hyperleukocytosis. Methods: We conducted a retrospective Study: data were collected from pediatric patients with acute leukemia initially presenting hyperleukocytosis at Maharat Nakhon Ratchasima Hospital from January 1, 2010 to December 31, 2019. Medical records were reviewed and the last follow-up date was March 31, 2020. Results: In all, data from 64 patients (14.7%) receiving a diagnosis of hyperleukocytosis were analyzed. Forty-nine patients (76.5%) received a diagnosis of acute lymphoblastic leukemia (ALL) and 15 patients (23.5%) received a diagnosis of acute myeloid leukemia (AML). Relapse rate of all  patients was 20.3% (24.4% in ALL vs. 13.3% in
AML). Three-year overall survival rate was 45.7% (50.2% in ALL vs. 33.3% in AML). Conclusion: Overall survival rate of pediatric patients with hyperleukocytosis was still unsatisfactory but similar to reports from other studies. Adjusting chemotherapy regimen, developing febrile neutropenia treatment guidelines and considering hematopoietic stem cell transplantation in this group of patients may improve survival outcomes.