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dc.contributor.authorZeller, Bernward
dc.contributor.authorGlosli, Heidi
dc.contributor.authorForestier, Erik
dc.contributor.authorHa, Shau-Yin
dc.contributor.authorJahnukainen, Kirsi
dc.contributor.authorJónsson, Ólafur G
dc.contributor.authorLausen, Birgitte
dc.contributor.authorPalle, Josefine
dc.contributor.authorHasle, Henrik
dc.contributor.authorAbrahamsson, Jonas
dc.date.accessioned2017-10-31T14:34:28Z
dc.date.available2017-10-31T14:34:28Z
dc.date.issued2017-08
dc.identifier.citationHyperleucocytosis in paediatric acute myeloid leukaemia - the challenge of white blood cell counts above 200 × 10(9) /l. The NOPHO experience 1984-2014. 2017, 178 (3):448-456 Br. J. Haematol.en
dc.identifier.issn1365-2141
dc.identifier.pmid28542715
dc.identifier.doi10.1111/bjh.14692
dc.identifier.urihttp://hdl.handle.net/2336/620333
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen
dc.description.abstractHyperleucocytosis in paediatric acute myeloid leukaemia (AML) is associated with increased morbidity and mortality. We studied hyperleucocytosis in 890 patients with AML aged 0-18 years registered in the Nordic Society of Paediatric Haematology and Oncology (NOPHO) registry, with special focus on very high white blood cell counts (WBC >200 × 10/l). Eighty-six patients (10%) had WBC 100-199 × 10(9) /l and 57 (6%) had WBC ≥200 × 10(9) /l. Patients with WBC ≥200 × 10(9) /l had a high frequency of t(9;11) and a paucity of trisomy 8. Due to the high frequency of deaths within the first 2 weeks (30% vs. 1% for all others), overall survival in this group was inferior to patients with WBC <200 × 10(9) /l (39% vs. 61%). Main cause of early death was intracranial haemorrhage and leucostasis. Twenty-six per cent of these patients never started antileukaemic protocol therapy. Leukapheresis or exchange transfusion was used in 24% of patients with hyperleucocytosis without impact on survival. Patients with hyperleucocytosis surviving the first week had identical survival as patients with lower WBC. We conclude that death within the first days after diagnosis is the major challenge in patients with high WBC and advocate rapid initiation of intensive chemotherapy.
dc.language.isoenen
dc.publisherWileyen
dc.relation.urlhttp://onlinelibrary.wiley.com/doi/10.1111/bjh.14692/epdfen
dc.rightsArchived with thanks to British journal of haematologyen
dc.subjectHvítblæðien
dc.subjectBörnen
dc.subjectHvítkornen
dc.subjectPED12en
dc.subject.meshAdolescenten
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshChromosomes, Human, Pair 11en
dc.subject.meshChromosomes, Human, Pair 9en
dc.subject.meshDatabases, Factualen
dc.subject.meshFemaleen
dc.subject.meshHong Kongen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshInfant, Newbornen
dc.subject.meshKaplan-Meier Estimateen
dc.subject.meshLeukemia, Myeloid, Acuteen
dc.subject.meshLeukocyte Counten
dc.subject.meshLeukocytosisen
dc.subject.meshMaleen
dc.subject.meshPrognosisen
dc.subject.meshRegistriesen
dc.subject.meshScandinavian and Nordic Countriesen
dc.subject.meshTrisomyen
dc.titleHyperleucocytosis in paediatric acute myeloid leukaemia - the challenge of white blood cell counts above 200 × 10(9) /l. The NOPHO experience 1984-2014.en
dc.typeArticleen
dc.contributor.department[ 1 ] Oslo Univ Hosp, Div Paediat & Adolescent Med, Mailbox 4950 Nydalen, N-0424 Oslo, Norway Show the Organization-Enhanced name(s) [ 2 ] Umea Univ Hosp, Dept Med Biosci, Genet, Umea, Sweden Show the Organization-Enhanced name(s) [ 3 ] Queen Mary Hosp, Dept Paediat & Adolescent Med, Hong Kong, Hong Kong, Peoples R China [ 4 ] HKPHOSG, Hong Kong, Hong Kong, Peoples R China Show the Organization-Enhanced name(s) [ 5 ] Univ Helsinki, Childrens Hosp, Helsinki, Finland Show the Organization-Enhanced name(s) [ 6 ] Helsinki Univ Cent Hosp, Helsinki, Finland Show the Organization-Enhanced name(s) [ 7 ] Landspitali Univ Hosp, Dept Paediat, Reykjavik, Iceland Show the Organization-Enhanced name(s) [ 8 ] Univ Copenhagen, Rigshosp, Dept Paediat & Adolescent Med, Copenhagen, Denmark Show the Organization-Enhanced name(s) [ 9 ] Uppsala Univ, Dept Womans & Childrens Hlth, Uppsala, Sweden Show the Organization-Enhanced name(s) [ 10 ] Aarhus Univ, Hosp Skejby, Dept Paediat, Aarhus, Denmark Show the Organization-Enhanced name(s) [ 11 ] Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Paediat, Gothenburg, Swedenen
dc.identifier.journalBritish journal of haematologyen
dc.rights.accessNational Consortium - Landsaðganguren
html.description.abstractHyperleucocytosis in paediatric acute myeloid leukaemia (AML) is associated with increased morbidity and mortality. We studied hyperleucocytosis in 890 patients with AML aged 0-18 years registered in the Nordic Society of Paediatric Haematology and Oncology (NOPHO) registry, with special focus on very high white blood cell counts (WBC >200 × 10/l). Eighty-six patients (10%) had WBC 100-199 × 10(9) /l and 57 (6%) had WBC ≥200 × 10(9) /l. Patients with WBC ≥200 × 10(9) /l had a high frequency of t(9;11) and a paucity of trisomy 8. Due to the high frequency of deaths within the first 2 weeks (30% vs. 1% for all others), overall survival in this group was inferior to patients with WBC <200 × 10(9) /l (39% vs. 61%). Main cause of early death was intracranial haemorrhage and leucostasis. Twenty-six per cent of these patients never started antileukaemic protocol therapy. Leukapheresis or exchange transfusion was used in 24% of patients with hyperleucocytosis without impact on survival. Patients with hyperleucocytosis surviving the first week had identical survival as patients with lower WBC. We conclude that death within the first days after diagnosis is the major challenge in patients with high WBC and advocate rapid initiation of intensive chemotherapy.


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