Hyperleukocytosis is associated with distinct genetic alterations and is an independent poor-risk factor in de novo acute myeloid leukemia patients

Journal
European Journal of Haematology
Journal Volume
101
Journal Issue
1
Pages
86
Date Issued
2018-07
Author(s)
Kuo, Yuan-Yeh
Li, Chi-Cheng
Lin, Chien-Ting
Tseng, Mei-Hsuan
Liu, Ming-Chih
Liu, Chia-Wen
DOI
URI
Abstract
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
Subjects
acute myeloid leukemia; genetic alterations; hyperleukocytosis; prognosis; transplantation
Publisher
Blackwell Publishing Ltd
Type
journal article

臺大位居世界頂尖大學之列，為永久珍藏及向國際展現本校豐碩的研究成果及學術能量，圖書館整合機構典藏（NTUR）與學術庫（AH）不同功能平台，成為臺大學術典藏NTU scholars。期能整合研究能量、促進交流合作、保存學術產出、推廣研究成果。

To permanently archive and promote researcher profiles and scholarly works, Library integrates the services of “NTU Repository” with “Academic Hub” to form NTU Scholars.

總館學科館員 (Main Library)
醫學圖書館學科館員 (Medical Library)
社會科學院辜振甫紀念圖書館學科館員 (Social Sciences Library)

開放取用是從使用者角度提升資訊取用性的社會運動，應用在學術研究上是透過將研究著作公開供使用者自由取閱，以促進學術傳播及因應期刊訂購費用逐年攀升。同時可加速研究發展、提升研究影響力，NTU Scholars即為本校的開放取用典藏（OA Archive）平台。（點選深入了解OA）

  • 請確認所上傳的全文是原創的內容，若該文件包含部分內容的版權非匯入者所有，或由第三方贊助與合作完成，請確認該版權所有者及第三方同意提供此授權。
    Please represent that the submission is your original work, and that you have the right to grant the rights to upload.
  • 若欲上傳已出版的全文電子檔，可使用Open policy finder網站查詢，以確認出版單位之版權政策。
    Please use Open policy finder to find a summary of permissions that are normally given as part of each publisher's copyright transfer agreement.

Built with DSpace-CRIS software - Extension maintained and optimized by 4Science