Impact of hyperleukocytosis on long-term outcomes
Figure 1A indicates that patients with hyperleukocytosis had a significantly lower 10-year PFS rate than patients without the hyperleukocytosis (44.4%±9.4% vs. 59.7%±5.5%, P =.041). Patients with hyperleukocytosis also had an inferior 10-year OS rate (49.4%±9.4% vs. 64.2%±5.4%, P =.051; Fig 1B), albeit this did not reach statistical significance. Further analysis showed similar 10-year PFS and OS rates (43.8%±13.3% vs. 44.9%±12.3%, P =.507; 46.9%±13.3% vs. 51.0%±12.3%,P =.907, respectively; Fig 1C and 1D) between the WBC count 50-100×109/L and WBC count ≥100×109/L subgroups.
Among patients with AML and hyperleukocytosis, male patients had a significantly lower 10-year PFS and OS rate than female patients (36.0%±10.4% vs. 58.1%±15.0%, P =.049; 40.0%±10.6% vs. 64.5%±14.5%,P =.023, respectively), and FAB M5 subtype had a significantly lower 10-year PFS and OS rate than another (34.1%±12.6% vs. 55.0%±12.1%, P =.017; 39.0%±13.0% vs. 60.0%±11.9%, P =.019, respectively). AML and hyperleukocytosis withFLT3-ITDhad similar 10-year PFS and OS rate to without FLT3-ITD(43.8%±18.1% vs. 44.6%±10.4%, P =.490; 56.3%±18.3% vs. 47.7%±10.4%, P =.845, respectively).However,CBF-AML with hyperleukocytosis had a significantly higher 10-year PFS and OS rate than other hyperleukocytosis in pediatric AML (66.7%±16.7% vs. 38.1%±10.4%,P =.023; 72.2%±15.8% vs. 42.9%±10.6%, P =.028, respectively).