title: Leukapheresis reduces 4-week mortality in acute myeloid leukemia patients with hyperleukocytosis - a retrospective study from a tertiary center.
abstract: Hyperleukocytosis in patients with acute myeloid leukemia (AML) can lead to leukostasis, which if left untreated, has a high mortality. While prompt cytoreductive chemotherapy is essential, treatment with leukapheresis is controversial. This study investigated the outcomes of patients with hyperleukocytosis who received leukapheresis. From 5596 encounters of patients with leukemia seen at Houston Methodist Hospital, we identified 26 patients who had newly diagnosed AML, WBC >50,000/μL, and received leukapheresis. We matched 26 patients who had similar baseline characteristics but did not receive leukapheresis. The primary endpoint was to compare the 28-day mortality rates between the treatment and the control groups. Secondary endpoints were 6-month, 1-year, and 2-year mortality rates. Using multivariate logistic regression analysis, leukapheresis was associated with significantly lower 28-day mortality rate (30.8% vs. 57.7%, p = .022). There was, however, no difference in long-term mortality rate. Our study demonstrates the short-term mortality benefit of using leukapheresis in AML patients presenting with hyperleukocytosis.
authors.affiliation: a Department of Medicine , Houston Methodist Hospital , Houston , TX , USA.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Nan
authors.affiliation: a Department of Medicine , Houston Methodist Hospital , Houston , TX , USA.
authors.forename: Qian
authors.initials: Q
authors.lastname: Qin
authors.affiliation: a Department of Medicine , Houston Methodist Hospital , Houston , TX , USA.
authors.forename: Cesar
authors.initials: C
authors.lastname: Gentille
authors.affiliation: b Houston Methodist Cancer Center, Houston Methodist Hospital , Houston , TX , USA.
authors.forename: Joe
authors.initials: J
authors.lastname: Ensor
authors.affiliation: c Department of Pathology and Genomic Medicine , Houston Methodist Hospital , Houston , TX , USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Leveque
authors.affiliation: b Houston Methodist Cancer Center, Houston Methodist Hospital , Houston , TX , USA.
authors.forename: Sai R
authors.initials: SR
authors.lastname: Pingali
authors.affiliation: b Houston Methodist Cancer Center, Houston Methodist Hospital , Houston , TX , USA.
authors.forename: Alexandria T
authors.initials: AT
authors.lastname: Phan
authors.affiliation: a Department of Medicine , Houston Methodist Hospital , Houston , TX , USA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Rice
authors.affiliation: b Houston Methodist Cancer Center, Houston Methodist Hospital , Houston , TX , USA.
authors.forename: Swaminathan
authors.initials: S
authors.lastname: Iyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007937:Leukapheresis / Q000379:methods; D015470:Leukemia, Myeloid, Acute / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies
keywords: Leukapheresis; hyperleukocytosis; leukemia