The Effect of Hyperleukocytosis on the Survival Rate for Childhood Acute Lymphoblastic Leukemia

Abstract

Background: Hyperleukocytosis or white blood cell count of more than 100,000/mm³, in childhood acute lymphoblastic leukemia can cause serious complications and may affect outcome of the treatment. Objective: To find the survival rate for childhood acute lymphoblastic leukemia in patients with or without hyperleukocytosis. Materials and Methods: The present study was a retrospective study conducted by reviewing medical records and pediatric cancer records of newly diagnosed acute lymphoblastic leukemia in Khon Kaen Hospital between January 1, 2014 and December 31, 2018. The demographic data, treatment protocols, complications, and treatment outcomes were recorded. The survival analysis of treatment outcomes was analyzed by Kaplan-Meier analysis. Results: One hundred sixteen children with acute lymphoblastic leukemia were included in the present study. Twenty-six (22.4%) of them had hyperleukocytosis. The male to female ratio was 1.6 to 1. The median age was five years old. The 5-year overall survival rate was 62.5% (95% CI 52.3 to 71.1). The 5-year survival rate of patients without hyperleukocytosis and patients with hyperleukocytosis were 70.2% (95% CI 58.7 to 79) and 36% (95% CI 17.5 to 54.9), respectively (p<0.01). Furthermore, the relapse rate tended to be the higher in the patients with hyperleukocytosis than the patients without hyperleukocytosis at 38.5% versus 23.3% (p=0.13). Conclusion: Hyperleukocytosis still remains an important factor that worsens the survival rate for childhood acute lymphoblastic leukemia. Keywords: Lymphoblastic leukemia; Hyperleukocytosis; Child; Survival rate