학술논문
Management of hyperleukocytosis in pediatric acute myeloid leukemia using immediate chemotherapy without leukapheresis: results from the NOPHO-DBH AML 2012 Protocol
Document Type
article
Author
Bernward Zeller; Nira Arad-Cohen; Daniel Cheuk; Barbara De Moerloose; Jose M. Fernandez Navarro; Henrik Hasle; Kirsi Jahnukainen; Kristian Lovvik Juul-Dam; Gertjan Kaspers; Zanna Kovalova; Olafur G. Jonsson; Birgitte Lausen; Monica Munthe-Kaas; Ulrika Noren Nystrom; Josefine Palle; Ramune Pasauliene; Cornelis J. Pronk; Kadri Saks; Anne Tierens; Jonas Abrahamsson
Source
Haematologica, Vol 999, Iss 1 (2024)
Subject
Language
English
ISSN
0390-6078
1592-8721
1592-8721
Abstract
Hyperleukocytosis (HL) in pediatric acute myeloid leukemia (AML) is associated with severe complications and inferior outcome. We report results on HL patients included in the NOPHO-DBH AML 2012 study. We recommended immediate start of full dose chemotherapy (etoposide [ETO] monotherapy for 5 days as part of the first course), avoiding leukapheresis (LA) and prephase chemotherapy (PCT). Of 714 included patients, 122 (17.1%) had HL, and 111 were treated according to the recommendations with ETO upfront without preceding LA or PCT. The first dose was applied the same day as the AML diagnosis or the day after in 94%. ETO was administered via peripheral veins in 37% of patients without major complications. After initiation of ETO the remaining WBC on days 2-5 was 69%, 36%, 17% and 8% of the pre-treatment level. On day 3, 81% had a WBC