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Scientific article
English

Pre-treatment with oral hydroxyurea prior to intensive chemotherapy improves early survival of patients with high hyperleukocytosis in acute myeloid leukemia

Published inLeukemia and Lymphoma, vol. 57, no. 10, p. 2281-2288
Publication date2016
Abstract

Acute myeloid leukemia with high white blood cell count (WBC) is a medical emergency. A reduction of tumor burden with hydroxyurea may prevent life-threatening complications induced by straight chemotherapy. To evaluate this strategy, we reviewed medical charts of adult patients admitted to our institution from 1997 to 2011 with non-promyelocytic AML and WBC over 50 G/L. One hundred and sixty patients were included with a median WBC of 120 G/L (range 50-450), 107 patients received hydroxyurea prior to chemotherapy, and 53 received emergency induction chemotherapy (CT). Hospital mortality was lower for patients treated with hydroxyurea (34% versus 19%, p = 0.047) even after adjusting for age (p < 0.01) and initial WBC count (p = 0.02). No evidence of any difference between treatment groups in terms of WBC decline kinetics and disease free survival (p = 0.87) was found. Oral hydroxyurea prior to chemotherapy seems a safe and efficient strategy to reduce early death of hyperleukocytic AML patients.

Keywords
  • Acute myeloid leukemia
  • Acute respiratory failure
  • Hydroxyurea
  • Hyperleukocytosis
  • Leukostasis
Affiliation Not a UNIGE publication
Citation (ISO format)
MAMEZ, Anne-Claire et al. Pre-treatment with oral hydroxyurea prior to intensive chemotherapy improves early survival of patients with high hyperleukocytosis in acute myeloid leukemia. In: Leukemia and Lymphoma, 2016, vol. 57, n° 10, p. 2281–2288. doi: 10.3109/10428194.2016.1142083
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ISSN of the journal1026-8022
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