https://scholars.lib.ntu.edu.tw/handle/123456789/619699
標題: | Hyperleukocytosis is associated with distinct genetic alterations and is an independent poor-risk factor in de novo acute myeloid leukemia patients | 作者: | FENG-MING TIEN HSIN-AN HOU CHENG-HONG TSAI JIH-LUH TANG Chen, Chien-Yuan Kuo, Yuan-Yeh Li, Chi-Cheng Lin, Chien-Ting MING YAO SHANG-YI HUANG BOR-SHENG KO SZU-CHUN HSU SHANG-JU WU WOEI TSAY Tseng, Mei-Hsuan Liu, Ming-Chih Liu, Chia-Wen LIANG-IN LIN WEN-CHIEN CHOU HWEI-FANG TIEN |
關鍵字: | acute myeloid leukemia; genetic alterations; hyperleukocytosis; prognosis; transplantation | 公開日期: | 七月-2018 | 出版社: | Blackwell Publishing Ltd | 卷: | 101 | 期: | 1 | 起(迄)頁: | 86 | 來源出版物: | European Journal of Haematology | 摘要: | Objectives: Acute myeloid leukemia (AML) with hyperleukocytosis (HL) is intuitively thought as a unique group with dismal prognosis. However, comprehensive studies regarding the genetic landscape and clinical outcome in this group of patients are limited. Methods: A total of 693 newly diagnosed de novo non-M3 AML patients were consecutively enrolled. We compared relevant mutations in 20 genes between AML patients with or without HL and exposed their prognostic implications. Results: Hyperleukocytosis, defined as initial white blood cell counts above 50 000/μL, occurred in 28.9% of AML patients. HL patients had higher incidences of FLT3-ITD, NPM1, DNMT3A, CEBPA, and TET2 mutations. Multivariate analysis demonstrated that HL was an independent poor prognostic factor for overall survival and disease-free survival in total patients, those with intermediate-risk cytogenetics and normal karyotype irrespective of genetic alterations. Intriguingly, HL predicted poor survival in CEBPA double mutated, NPM1 + /FLT3-ITD- and NPM1-/FLT3-ITD- patients. Further, HL patients who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) in first complete remission (CR) had a significantly longer overall survival and disease-free survival than those without allo-HSCT. Conclusions: Hyperleukocytosis is an independent poor prognostic factor irrespective of cytogenetics and mutation status. Allo-HSCT in first CR seems to ameliorate the poor prognostic impact of HL. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85047470691&doi=10.1111%2fejh.13073&partnerID=40&md5=edbfa2667791fc8b569b73e9dff36bd9 https://scholars.lib.ntu.edu.tw/handle/123456789/619699 |
ISSN: | 0902-4441 | DOI: | 10.1111/ejh.13073 |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。