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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References(25)

References

[1]	Malard F,Mohty M. Acute lymphoblastic leukaemia[J]. Lancet,2020,395(10230):1146-1162. doi: 10.1016/S0140-6736(19)33018-1
[2]	Ni X,Li Z,Li X,et al. Socioeconomic inequalities in cancer incidence and access to health services among children and adolescents in China: A cross-sectional study[J]. Lancet,2022,400(10357):1020-1032. doi: 10.1016/S0140-6736(22)01541-0
[3]	Hunger S P,Mullighan C G. Acute lymphoblastic leukemia in children[J]. N Engl J Med,2015,373(16):1541-1552. doi: 10.1056/NEJMra1400972
[4]	Korkmaz S. The management of hyperleukocytosis in 2017: Do we still need leukapheresis?[J]. Transfus Apher Sci,2018,57(1):4-7. doi: 10.1016/j.transci.2018.02.006
[5]	Zhang D,Zhu Y,Jin Y,et al. Leukapheresis and hyperleukocytosis,past and future[J]. Int J Gen Med,2021,14:3457-3467. doi: 10.2147/IJGM.S321787
[6]	Dai Q,Zhang G,Yang H,et al. Clinical features and outcome of pediatric acute lymphoblastic leukemia with low peripheral blood blast cell count at diagnosis[J]. Medicine (Baltimore),2021,100(4):e24518.
[7]	李晨,刘炜,王亚峰,等. 单中心CCLG-ALL 2018方案治疗MLL基因重排阳性儿童急性淋巴细胞白血病的临床研究[J]. 中国癌症防治杂志,2023,15(6):637-643. doi: 10.3969/j.issn.1674-5671.2023.06.07
[8]	Abla O,Angelini P,Di Giuseppe G,et al. Early complications of hyperleukocytosis and leukapheresis in childhood acute leukemias[J]. J Pediatr Hematol Oncol,2016,38(2):111-117. doi: 10.1097/MPH.0000000000000490
[9]	Park K M,Yang E J,Lee J M,et al. Treatment outcome in pediatric acute lymphoblastic leukemia with hyperleukocytosis in the yeungnam region of korea: A multicenter retrospective study[J]. J Pediatr Hematol Oncol,2020,42(4):275-280. doi: 10.1097/MPH.0000000000001771
[10]	Wang Y,Xue Y J,Jia Y P,et al. Outcomes of adolescent patients with acute lymphoblastic leukemia: Long-term follow-up of 335 patients[J]. Clin Lymphoma Myeloma Leuk,2021,21(8):e658-e665. doi: 10.1016/j.clml.2021.03.008
[11]	Burke M J,Devidas M,Chen Z,et al. Outcomes in adolescent and young adult patients (16 to 30 years) compared to younger patients treated for high-risk B-lymphoblastic leukemia: Report from Children's Oncology Group Study AALL0232.[J]. LEUKEMIA,2022,36:648-655. doi: 10.1038/s41375-021-01460-6
[12]	兰洋,陈晓娟,邹尧,等. CCLG-ALL2008方案治疗10岁以上儿童及青少年急性淋巴细胞白血病的疗效分析[J]. 中国当代儿科杂志,2019,21(5):405-410.
[13]	El C F,Keng M,Ballen K K. MLL-Rearranged acute lymphoblastic leukemia[J]. Curr Hematol Malig Rep,2020,15(2):83-89. doi: 10.1007/s11899-020-00582-5
[14]	Agrwal S,Sahi P K. National comprehensive cancer network guidelines for pediatric acute lLymphoblastic leukemia[J]. Indian Pediatr,2020,57(6):561-564. doi: 10.1007/s13312-020-1855-1
[15]	Oakley J,Williams E K,Zhang D Y,et al. Redefining hyperviscosity in acute leukemia: Implications for red cell transfusions[J]. Blood,2021,138(Supplement 1): 3253.
[16]	Jum Ah H,Chitsaz M,Kundrapu S. Leukostasis aggravated by red blood cell transfusion in a chronic lymphocytic leukemia patient[J]. American Journal of Clinical Pathology,2021,156(Supplement_1):S162-S163.
[17]	Durfee E M. Tumor lysis syndrome[J]. Crit Care Nurse,2022,42(3):19-25. doi: 10.4037/ccn2022795
[18]	黄礼彬. 儿童肿瘤溶解综合征诊疗指南[J]. 中国实用儿科杂志,2021,36(12):890-896.
[19]	孟广强,李星,王立茹. 高白细胞急性白血病白细胞淤滞研究进展[J]. 内科急危重症杂志,2020,26(2):152-154.
[20]	D'Angio M,Valsecchi M G,Testi A M,et al. Clinical features and outcome of SIL/TAL1-positive T-cell acute lymphoblastic leukemia in children and adolescents: A 10-year experience of the AIEOP group[J]. Haematologica,2015,100(1):e10-e13. doi: 10.3324/haematol.2014.112151
[21]	刘潇,李伟京,赵晓曦,等. SIL-TAL1融合基因阳性的儿童急性T淋巴细胞白血病的临床特征及其治疗研究[J]. 中国实验血液学杂志,2016,24(3):681-686.
[22]	蔡春霞,郑湧智,李健,等. 高超二倍体核型儿童急性淋巴细胞白血病的临床特征及预后——福建省多中心回顾性研究[J]. 中国当代儿科杂志,2023,25(1):38-45.
[23]	多中心研究协作组中国抗癌协会小儿肿瘤专业委员会急性淋巴细胞白血病. CCCG-ALL-2015方案多中心临床报告[J]. 中华儿科杂志,2022,60(10):1002-1010. doi: 10.3760/cma.j.cn112140-20220719-00895
[24]	Cui L,Li Z G,Chai Y H,et al. Outcome of children with newly diagnosed acute lymphoblastic leukemia treated with CCLG-ALL 2008: The first nation-wide prospective multicenter study in China.[J]. Am J Hematol,2018,93:913-920. doi: 10.1002/ajh.25124
[25]	蔡娇阳,王宁玲,蒋慧,等. 儿童急性淋巴细胞白血病2005方案多中心远期临床报告[J]. 中华儿科杂志,2018,S6(7):511-517. doi: 10.3760/cma.j.issn.0578-1310.2018.07.008

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