文章：

高白细胞性FLT3-ITD突变急性髓系白血病有症状患者或可从白细胞分离术中获益

Symptomatic Patients with Hyperleukocytic FLT3-ITD Mutated Acute Myeloid Leukemia Might Benefit from Leukapheresis

原文发布日期：21 December 2023

DOI: 10.3390/cancers16010058

类型: Article

开放获取: 是

英文摘要：

Purpose: We aimed to identify subsets of patients who benefit from emergency LA and to establish a therapeutic algorithm for AML patients with hyperleukocytosis. Methods: In this single-center retrospective cohort study, a total of 20 consecutive patients underwent LA because of their clinical symptoms. Overall survival (OS) analysis was conducted using the Kaplan–Meier plot method. Univariate and multivariate analyses (using multiple logistic regression) were performed. At the time of diagnosis, all patients received a standard diagnostic workup for AML including FLT3-ITD mutational analysis. Results: FLT3-ITD mut AML patients receiving LA had a median OS of 437 days (range 5–2379 days) with a corresponding 14-day survival of 92.3%, while FLT3 wt AML patients displayed a significantly lower median OS of only 5 days (range 1–203 days) with a corresponding 14-day survival of 14.3% (p= 0.0001). Conclusions: Among patients with clinical symptoms of leukostasis, the subset of FLT3-ITD mut AML patients showed a better outcome with lower early mortality after emergency LA. Based on these observations, we established a therapeutic algorithm for AML patients with hyperleukocytosis.

摘要翻译： 

目的：本研究旨在明确可从急诊白细胞分离术中获益的患者亚群，并为高白细胞血症急性髓系白血病患者建立治疗决策流程。方法：本单中心回顾性队列研究连续纳入20例因临床症状接受白细胞分离术的患者。采用Kaplan-Meier曲线法进行总生存期分析，并行单因素及多因素逻辑回归分析。所有患者在确诊时均接受包括FLT3-ITD突变检测在内的标准AML诊断检查。结果：接受白细胞分离术的FLT3-ITD突变AML患者中位总生存期为437天（范围5-2379天），14天生存率达92.3%；而FLT3野生型AML患者中位总生存期显著降低至5天（范围1-203天），14天生存率仅为14.3%（p=0.0001）。结论：在出现白细胞淤滞临床症状的患者中，FLT3-ITD突变AML亚组患者经急诊白细胞分离术后早期死亡率更低，预后更佳。基于这些发现，我们建立了高白细胞血症AML患者的治疗决策流程。

原文链接：

Symptomatic Patients with Hyperleukocytic FLT3-ITD Mutated Acute Myeloid Leukemia Might Benefit from Leukapheresis