Clinical Features and Prognosiss of Pediatric Acute Lymphoblastic Leukemia with Hyperleukocytosis

Haijin LI; Huiyuan LI; Xinmiao LIU; Yue TIAN; Na LI; Zhengcheng DUAN; Xin TIAN

doi:10.12259/j.issn.2095-610X.S20240716

Volume 45 Issue 7

Jul. 2024

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Haijin LI, Huiyuan LI, Xinmiao LIU, Yue TIAN, Na LI, Zhengcheng DUAN, Xin TIAN. Clinical Features and Prognosiss of Pediatric Acute Lymphoblastic Leukemia with Hyperleukocytosis[J]. Journal of Kunming Medical University, 2024, 45(7): 105-112. doi: 10.12259/j.issn.2095-610X.S20240716

Citation:

Haijin LI, Huiyuan LI, Xinmiao LIU, Yue TIAN, Na LI, Zhengcheng DUAN, Xin TIAN. Clinical Features and Prognosiss of Pediatric Acute Lymphoblastic Leukemia with Hyperleukocytosis[J]. Journal of Kunming Medical University, 2024, 45(7): 105-112. doi: 10.12259/j.issn.2095-610X.S20240716

Citation:

Haijin LI, Huiyuan LI, Xinmiao LIU, Yue TIAN, Na LI, Zhengcheng DUAN, Xin TIAN. Clinical Features and Prognosiss of Pediatric Acute Lymphoblastic Leukemia with Hyperleukocytosis[J]. Journal of Kunming Medical University, 2024, 45(7): 105-112. doi: 10.12259/j.issn.2095-610X.S20240716

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Clinical Features and Prognosiss of Pediatric Acute Lymphoblastic Leukemia with Hyperleukocytosis

doi: 10.12259/j.issn.2095-610X.S20240716

Haijin LI¹,
Huiyuan LI¹,
Xinmiao LIU¹,
Yue TIAN¹,
Na LI¹,
Zhengcheng DUAN^{2
,
,},
Xin TIAN^{1
,
,}

1.
Dept. of Hematology and Oncology，Kunming Children’s Hospital/Children’s Hospital Affiliated to Kunming Medical University，Kunming Yunnan 650228
2.
Dept. of Pediatric，Kunming Maternal and Child Health Hospital，Kunming Yunnan 650031，China

Received Date: 2024-03-06
Available Online: 2024-06-17
Publish Date: 2024-07-25

Abstract

Abstract

Objective To investigate the clinical features and prognostic factors of pediatric acute lymphoblastic leukemia with hyperleukocytosis （HL-ALL）. Methods The clinical data of 427 newly diagnosed ALL children admitted to the Department of Hematology and Oncology of Kunming Children’ s Hospital from January 2019 to July 2022 were retrospectively analyzed. According to the initial white blood cell count （WBC） of 100×10⁹/L, the children were divided into the hyperleukocytosis group and the non-hyperleukocytosis group. The clinical characteristics, major laboratory tests, overall survival （OS） and event-free survival （EFS） were compared between the two groups. Results There were 250 males and 177 females, with a male-to-female ratio of 1.41∶1. There were 92 cases （21.5%） in the hyperleukocytosis group and 335 cases （78.5%） in the non-hyperleukocytosis group. Compared with the non-hyperleukocytosis group, the hyperleukocytosis group had significantly higher proportions of children aged < 1 year and > 10 years, T lymphoblastic leukemia （T-ALL）, moderate to severe hepatosplenomegaly, and high-risk risk （P < 0.05）, as well as significantly higher percentage of immature cells at initial diagnosis, serum uric acid （UA） level, and lactate dehydrogenase （LDH） level （P < 0.05）. The platelet count （PLT） and the proportion of hyperdiploidy at diagnosis were lower （P <0.05）. The 3-year EFS and OS of the hyperleukocytosis group were lower than those of the non-hyperleukocytosis group. WBC ≥100×10⁹/L at diagnosis, age >10 years, age < 1 year, T-ALL, high-risk, D15 MRD positive, D33 MRD positive, CNSL, MLL rearrangement, and MEF2D rearrangement were independent risk factors for EFS and OS rates in children with ALL （P < 0.05）. Conclusion The children with HL-ALL usually have a higher percentage of peripheral blood immature cells, elevated serum UA and LDH, and are often accompanied by age of onset <1 or > 10 years old, T-ALL, hepatosplenomegaly, and high risk. The early treatment response and prognosis of the children with HL-ALL are poor.
- Acute lymphoblastic leukemia,
- Hyperleukocytosis,
- Children

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