The results of treatment in children with AML and initial hyperleucocytosis according to the AML-MM-2006 Protocol

I. I. Kalinina; Калинина И. И.; N. V. Zacharov; Захаров Н. В.; D. A. Venev; Венёв Д. А.; T. Yu. Salimova; Салимова Т. Ю.; U. N. Petrova; Петрова У. Н.; O. V. Goronkova; Горонкова О. В.; D. D. Baydildina; Байдильдина Д. Д.; E. V. Suntcova; Сунцова Е. В.; M. N. Sadovskay; Садовская М. Н.; D. A. Evseev; Евсеев Д. А.; V. E. Matveev; Матвеев В. Е.; K. S. Antonova; Антонова К. С.; I. G. Khamin; Хамин И. Г.; M. E. Dubrovina; Дубровина М. Э.; Yu. V. Olshanskaya; Ольшанская Ю. В.; E. A. Zerkalenkova; Зеркаленкова Е. А.; A. I. Mandgieva; Манджиева А. И.; D. N. Balashov; Балашов Д. Н.; L. N. Shelikhova; Шелихова Л. Н.; M. A. Maschan; Масчан М. А.; G. A. Novichkova; Новичкова Г. А.; A. A. Maschan; Масчан А. А.

doi:10.24287/1726-1708-2020-19-1-9-17

The results of treatment in children with AML and initial hyperleucocytosis according to the AML-MM-2006 Protocol

Authors: Kalinina I.I.¹, Zacharov N.V.², Venev D.A.¹, Salimova T.Y.¹, Petrova U.N.¹, Goronkova O.V.¹, Baydildina D.D.¹, Suntcova E.V.¹, Sadovskay M.N.¹, Evseev D.A.¹, Matveev V.E.¹, Antonova K.S.¹, Khamin I.G.¹, Dubrovina M.E.¹, Olshanskaya Y.V.¹, Zerkalenkova E.A.¹, Mandgieva A.I.¹, Balashov D.N.¹, Shelikhova L.N.¹, Maschan M.A.¹, Novichkova G.A.¹, Maschan A.A.¹
Affiliations:
1. Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation
2. Krasnoyarsk Clinical Center of maternity and childhood
Issue: Vol 19, No 1 (2020)
Pages: 9-17
Section: PROMISING STUDIES
Submitted: 26.03.2020
Accepted: 26.03.2020
Published: 26.03.2020
URL: https://hemoncim.com/jour/article/view/301
DOI: https://doi.org/10.24287/1726-1708-2020-19-1-9-17
ID: 301

Cite item

Full Text

Abstract
About the authors
References
Supplementary files
Statistics

Abstract

The prognostic role of HL in AML in children is a matter of a discussion. 185 patients were treated for AML in our center, 36 of 185 had HL (19.5%). The study was approved by the Independent Ethics Committee of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology. Median Le was 97 × 109 /l (50–428 ± 109 /l). Standard risk group were 4 pts, intermediate – 8, hight – 24. The most common variants were M4/M5 in FAB classification – 30 pts and genetic rearrangement – MLL in 15 of 36 pts. Thirty-five patients with HL received cytoreduction course and ADE. After that, all patients received ADE and 21 pts second part of induction – course HAM. Remission was achieved in 27 (75%) out of 36 pts. HSCT was performed in 23 pts. Thirteen out of 36 patients with HL died: 4 (30%) – due to leukostasis complications. OS for HL group was 0.56 ± 0.09, for non-HL group was 0.75 ± 0.04, p = 0.005; EFS (HL) 0.42 ± 0.09, EFS (non-HL) 0.49 ± 0.04, p = 0.026. Also, differences in I CR achievement, median of remission length and death before remission between two groups were statistically significant (p = 0.036; p = 0.028; p = 0.021 respectively). OS and EFS in patients with M4/M5 with HL > 50 ± 109 /l were better than in patients all FAB with HL > 100 ± 109 /l, OS 0.71 ± 0.1 vs OS 0.43 ± 0.1 (p = 0.012); EFS 0.54 ± 0.1 vs EFS 0.29 ± 0.1 (p = 0.038) respectively. HL significantly worsens OS and EFS in children with AML.

Keywords

children, acute myeloid leukemia, hyperleukocytosis, leukostasis

About the authors

I. I. Kalinina

Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation

Author for correspondence.
Email: irina.kalinina@fccho-moscow.ru
ORCID iD: 0000-0002-0813-5626

MD, Pediatrician Hematologist, Department of Pediatric Hematology/Oncology,

117997, Moscow, Samory Mashela st., 1

Russian Federation

References

Campana D., Pui C.H. Childhood Leukemia. Abeloff’s Clinical Oncology: Fifth Edition 2013.
Greenwood M.J. Seftel M.D., Richardson C., Barbaric D., Barnett M.J., Bruyere H., et al. Leukocyte count as a predictor of death during remission induction in acute myeloid leukemia. Leuk Lymphoma 2006; 47 (7): 1245–52.
Pastore F., Pastore A., Wittmann G., Hiddemann W., Spiekermann K. The role of therapeutic leukapheresis in hyperleukocytotic AML. PLoS One, 2014; 9 (4): e95062.
Zeller B., Glosli H., Forestier E., Ha S.‐ Yin, Jahnukainen K., Jónsson Ó.G., et al. Hyperleucocytosis in paediatric acute myeloid leukaemia – the challenge of white blood cell counts above 200×109/l. The NOPHO experience 1984–2014. Br J Haematol 2017; Aug; 178 (3): 448–56. doi: 10.1111/bjh.14692. Epub 2017 May 25.
Porcu P., Farag S., Marcucci G., Cataland S.R., Kennedy M.S., Bissell M. Leukocytoreduction for acute leukemia. Ther Apher 2002 Feb; 6 (1): 15–23.
Robak T., Wrzesien-Kus A., Lech-Maranda, Kowal E.M., Dmoszynska A. Combination regimen of cladribine (2-Chlorodeoxyadenosine), cytarabine and G-CSF (CLAG) as induction therapy for patients with relapsed or refractory acute myeloid leukemia. Leuk Lymphoma 2000; Sep; 39 (1–2): 121–9.
Porcu P., Cripe L.D., Ng E.W., Bhatia S., Danielson C.M., Orazi A., McCarthy L.J. Hyperleukocytic leukemias and leukostasis: A review of pathophysiology, clinical presentation and management. Leukemia and Lymphoma 2000; 39 (1–2): 1–18.
Ganzel C., Becker J., Mintz P.D., Lazarus H.M., Rowe J.M. Hyperleukocytosis, leukostasis and leukapheresis: Practice management. Blood Rev 2012; May; 26 (3): 117–22. doi: 10.1016/j.blre.2012.01.003. Epub 2012 Feb 23.
Röllig C., Ehninger G. How I treat hyperleukocytosis in acute myeloid leukemia. Blood 2015 May 21; 125 (21): 3246–52. doi: 10.1182/blood-2014-10-551507. Epub 2015 Mar 16.

Supplementary files

Supplementary Files

Action

1. JATS XML

Download

Username
Password
Remember me

Forgot password?	Register

Username
Password
Remember me

Forgot password?	Register