Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2021 Mar 19;11(1):6426. doi: 10.1038/s41598-021-85918-8.
Leukapheresis is used for the mechanical removal of leukaemic cells in hyperleukocytosis. However, the effectiveness of leukapheresis remains unclear due to selection and confounding factors in the cohorts. We compared the effectiveness of leukapheresis among the subgroups according to either the 2016 World Health Organization classification or the number of cytogenetic abnormalities with a retrospective, single-centre study from January 2009 to December 2018. Acute myeloid leukaemia (AML, n = 212) and acute lymphoblastic leukaemia (ALL, n = 97) were included. The 30-day survival rates (95% confidence interval, 95% CI) for AML and ALL were 86.3% (81.6-90.9%) and 94.8% (90.3-99.2%), respectively. For AML, 'primary AML with myelodysplasia-related changes' and 'AML with biallelic mutation of CEBPA' showed better 30-day survival outcomes (P = 0.026) than the other subgroups. A higher platelet count after leukapheresis was associated with better 30-day survival in AML patients (P = 0.029). A decrease in blast percentage count after leukapheresis was associated with better 30-day survival in ALL patients (P = 0.034). Our study suggested that prophylactic platelet transfusion to raise the platelet count to 50 × 10/L or greater might improve clinical outcome in AML patients undergoing leukapheresis.
白细胞去除术用于去除白细胞增多症中的白血病细胞。然而，由于队列选择和混杂因素，白细胞去除术的效果仍不清楚。我们通过回顾性单中心研究比较了根据 2016 年世界卫生组织分类或细胞遗传学异常数量分组的白细胞去除术的效果，该研究纳入了 2009 年 1 月至 2018 年 12 月的急性髓细胞白血病（AML，n=212）和急性淋巴细胞白血病（ALL，n=97）患者。AML 和 ALL 的 30 天生存率（95%置信区间，95%CI）分别为 86.3%（81.6-90.9%）和 94.8%（90.3-99.2%）。对于 AML，“伴有骨髓增生异常相关改变的原发性 AML”和“CEBPA 双等位基因突变的 AML”的 30 天生存结局优于其他亚组（P=0.026）。白细胞去除术后血小板计数升高与 AML 患者 30 天生存更好相关（P=0.029）。白细胞去除术后原始细胞百分比降低与 ALL 患者 30 天生存更好相关（P=0.034）。本研究表明，预防性血小板输注将血小板计数提高至 50×10/L 或更高可能改善 AML 患者白细胞去除术后的临床结局。
