Farid Kiavasch Mohammad Nejad, Sauer Tim, Schmitt Michael, Müller-Tidow Carsten, Schmitt Anita
Department of Internal Medicine V, University Hospital Heidelberg, 69120 Heidelberg, Germany.
German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), German Cancer Consortium (DKTK), 69120 Heidelberg, Germany.
Cancers (Basel). 2023 Dec 21;16(1):58. doi: 10.3390/cancers16010058.
We aimed to identify subsets of patients who benefit from emergency LA and to establish a therapeutic algorithm for AML patients with hyperleukocytosis.
In this single-center retrospective cohort study, a total of 20 consecutive patients underwent LA because of their clinical symptoms. Overall survival (OS) analysis was conducted using the Kaplan-Meier plot method. Univariate and multivariate analyses (using multiple logistic regression) were performed. At the time of diagnosis, all patients received a standard diagnostic workup for AML including FLT3-ITD mutational analysis.
FLT3-ITD mut AML patients receiving LA had a median OS of 437 days (range 5-2379 days) with a corresponding 14-day survival of 92.3%, while FLT3 wt AML patients displayed a significantly lower median OS of only 5 days (range 1-203 days) with a corresponding 14-day survival of 14.3% ( = 0.0001).
Among patients with clinical symptoms of leukostasis, the subset of FLT3-ITD mut AML patients showed a better outcome with lower early mortality after emergency LA. Based on these observations, we established a therapeutic algorithm for AML patients with hyperleukocytosis.
我们旨在识别从紧急白细胞去除术（LA）中获益的患者亚组，并为高白细胞血症的急性髓系白血病（AML）患者建立一种治疗算法。
在这项单中心回顾性队列研究中，共有20例连续患者因临床症状接受了LA。使用Kaplan-Meier曲线法进行总生存（OS）分析。进行了单因素和多因素分析（使用多元逻辑回归）。在诊断时，所有患者均接受了包括FLT3-ITD突变分析在内的AML标准诊断检查。
接受LA的FLT3-ITD突变AML患者的中位OS为437天（范围5-2379天），相应的14天生存率为92.3%，而FLT3野生型AML患者的中位OS显著更低，仅为5天（范围1-203天），相应的14天生存率为14.3%（P = 0.0001）。
在有白细胞淤滞临床症状的患者中，FLT3-ITD突变AML患者亚组在紧急LA后早期死亡率较低，预后较好。基于这些观察结果，我们为高白细胞血症的AML患者建立了一种治疗算法。
