Initial respiratory status in hyperleukocytic acute myeloid leukemia: prognostic significance and effect of leukapheresis. Issue 6 (2nd June 2016) - Van de Louw, Andry
Abstract: This study investigated whether initial respiratory status in hyperleukocytic acute myeloid leukemia (AML), as defined by oxygen/ventilatory support, is (1) associated with early mortality and overall survival and (2) improved after leukapheresis. A retrospective chart review of 89 patients requiring leukapheresis was performed. White blood cell count (WBC) decreased from 153 (56–475) × 10 9 /L to 60 (17–259) × 10 9 /L after first leukapheresis ( p < 0.01). Initial respiratory status was room air ( n = 40), low ( n = 31) or high flow oxygen therapy ( n = 8) or mechanical ventilation ( n = 10). As compared to admission, respiratory status significantly deteriorated after both first and second leukapheresis ( p < 0.01) and was not different at day 5 for patients still alive ( p = 0.131). Both day 28 mortality and overall survival were significantly affected by initial respiratory status ( p < 0.01). Despite being effective in reducing WBC, leukapheresis did not improve respiratory status of hyperleukocytic AML patients, a factor strongly associated with survival.