PMID- 26670831
OWN - NLM
STAT- MEDLINE
DCOM- 20160718
LR  - 20160216
IS  - 1545-5017 (Electronic)
IS  - 1545-5009 (Linking)
VI  - 63
IP  - 4
DP  - 2016 Apr
TI  - Exchange Transfusion and Leukapheresis in Pediatric Patients with AML With High 
      Risk of Early Death by Bleeding and Leukostasis.
PG  - 640-5
LID - 10.1002/pbc.25855 [doi]
AB  - BACKGROUND: The risk of early death (ED) by bleeding/leukostasis is high in 
      patients with AML with hyperleukocytosis (>100,000/mul). Within the pediatric 
      AML-BFM (Berlin-Frankfurt-Munster) 98/04 studies, emergency strategies for these 
      children included exchange transfusion (ET) or leukapheresis (LPh). Risk factors 
      for ED and interventions performed were analyzed. PATIENTS: Two hundred 
      thirty-eight of 1,251 (19%) patients with AML presented with hyperleukocytosis; 
      23 of 1,251 (1.8%) patients died of bleeding/leukostasis. RESULTS: ED due to 
      bleeding/leukostasis was highest at white blood cell (WBC) count >200,000/mul 
      (14.3%). ED rates were even higher (20%) in patients with FAB 
      (French-American-British) M4/M5 and hyperleukocytosis >200,000/mul. Patients with 
      WBC >200,000/mul did slightly better with ET/LPh compared to those without ET/LPh 
      (ED rate 7.5% vs. 21.2%, P = 0.055). Multivariate WBC >200,000/mul was of 
      strongest prognostic significance for ED (P(chi(2) ) <0.0001). CONCLUSION: Our data 
      confirm the high risk of bleeding/leukostasis in patients with hyperleukocytosis. 
      ET/LPh shows a trend toward reduced ED rate due to bleeding/leukostasis and is 
      recommended at WBC >200,000/mul, and in FAB M4/M5 even at lower WBC.
CI  - (c) 2015 Wiley Periodicals, Inc.
FAU - Creutzig, Ursula
AU  - Creutzig U
AD  - Department of Pediatric Hematology and Oncology Children's Hospital, Hannover 
      Medical School, Hannover, Germany.
FAU - Rossig, Claudia
AU  - Rossig C
AD  - Department of Pediatric Hematology and Oncology, University Children's Hospital 
      Muenster, Muenster, Germany.
FAU - Dworzak, Michael
AU  - Dworzak M
AD  - Department of Pediatrics, St. Anna Children's Hospital and Children's Cancer 
      Research Institute, Medical University of Vienna, Vienna, Austria.
FAU - Stary, Jan
AU  - Stary J
AD  - Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles 
      University and University Hospital Motol, Prague, Czech Republic.
FAU - von Stackelberg, Arend
AU  - von Stackelberg A
AD  - Department of Pediatric Oncology/Hematology, Charite University Medical Center 
      Berlin, Berlin, Germany.
FAU - Wossmann, Wilhelm
AU  - Wossmann W
AD  - Department of Pediatric Hematology and Oncology, Justus-Liebig-University, 
      Giessen, Germany.
FAU - Zimmermann, Martin
AU  - Zimmermann M
AD  - Department of Pediatric Hematology and Oncology Children's Hospital, Hannover 
      Medical School, Hannover, Germany.
FAU - Reinhardt, Dirk
AU  - Reinhardt D
AD  - Department of Pediatric Hematology-Oncology, University of Duisburg-Essen, Essen, 
      Germany.
LA  - eng
PT  - Journal Article
DEP - 20151216
PL  - United States
TA  - Pediatr Blood Cancer
JT  - Pediatric blood & cancer
JID - 101186624
SB  - IM
MH  - *Blood Transfusion
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Hemorrhage/etiology/mortality/prevention & control
MH  - Humans
MH  - Infant
MH  - *Leukapheresis
MH  - Leukemia, Myeloid, Acute/*complications/mortality/*therapy
MH  - Leukostasis/etiology/mortality/prevention & control
MH  - Male
MH  - Proportional Hazards Models
MH  - Risk Factors
OTO - NOTNLM
OT  - bleeding
OT  - early death
OT  - exchange transfusion
OT  - leukapheresis
OT  - leukostasis
OT  - pediatric AML
EDAT- 2015/12/17 06:00
MHDA- 2016/07/19 06:00
CRDT- 2015/12/17 06:00
PHST- 2015/09/01 00:00 [received]
PHST- 2015/10/21 00:00 [revised]
PHST- 2015/11/04 00:00 [accepted]
PHST- 2015/12/17 06:00 [entrez]
PHST- 2015/12/17 06:00 [pubmed]
PHST- 2016/07/19 06:00 [medline]
AID - 10.1002/pbc.25855 [doi]
PST - ppublish
SO  - Pediatr Blood Cancer. 2016 Apr;63(4):640-5. doi: 10.1002/pbc.25855. Epub 2015 Dec 
      16.