Leukapheresis Does Not Improve Early Survival Outcome of Acute Myeloid Leukemia with Leukostasis Patients – A Dual-Center Retrospective Cohort Study

Figures & data

Table 1 Baseline Characteristics of AML Patients

Characteristics	Total n=38	Leukapheresis + Chemotherapy n=11	Chemotherapy Only n=27	P value
Age (years) (SD)	42.45 (15.52)	40.82 (8.67)	43.11 (17.67)	0.685
Gender				0.762
Male (%)	17 (44.7%)	4 (36.4%)	13 (48.1%)
Female (%)	21 (55.3%)	7 (63.6%)	14 (51.9%)
Body Mass Index (Kg/m^2) (median)	21.125 (11.98–36.57)	21.96 (11.98–30.08)	21.71 (12.33–36.57)	0.552
Hemoglobin (g/dl) (SD)	7.527 (2.227)	6.694 (2.165)	7.866 (2.200)	0.144
MCV (Femtolitre) (SD)	87.458 (5.689)	87 (7.1255)	87.644 (5.140)	0.756
Leukocyte (mm^3) (median)	205,835 (105,000–847,000)	353,830 (143,360–847,000)	170,930 (105,000–369,100)	0.003
Thrombocyte (mm^3) (median)	39,550 (6000–665,000)	57,900 (6000–125,000)	34,000 (7540–665,000)	0.509
Blast (%) (median)	90 (42–97)	90 (54–97)	90 (42–96)	0.485
Creatinine (mg/dl) (median)	1.08 (0.46–6.00)	1.41 (0.56–5.48)	1.03 (0.46–6.00)	0.573
Respiratory leukostasis (%)	21 (55.3%)	2 (18.2%)	19 (70.4%)	0.010
Central Nervous System Leukostasis (%)	20 (52.6%)	5 (45.5%)	15 (55.6%)	0.836
Cardiovascular Leukostasis (%)	10 (26.3%)	3 (27.3%)	7 (25.9%)	1.000
Gastrointestinal Leukostasis (%)	22 (57.9%)	4 (36.4%)	18 (66.7%)	0.176
Tumor Lysis Syndrome (%)	15 (39.5%)	3 (27.3%)	12 (44.4%)	0.538
Disseminated Intravascular Coagulation (%)	13 (34.2%)	3 (27.3%)	10 (37%)	0.843
Chronic Comorbidities (%)	14 (36.8%)	2 (18.2%)	12 (44.4%)	0.250

Figure 1 Survival of acute myeloid leukemia patients with leukostasis based on chemotherapy plus leukapheresis treatment and chemotherapy only treatment. (A) 28 Days; (B) 21 days; (C) 14 days; (D) 7 days.

Table 2 Univariate Analysis and Multivariate Analysis for 28-Day Survival of Acute Myeloid Leukemia Patients

Variable	Category	Univariate Analysis			Multivariate Analysis
		Hazard Ratio	95% CI	P value	Hazard Ratio		95% CI	P value
Therapy	Chemotherapy + leukapheresis	1.140	0.396–3.283	0.809	–		–	–
	Chemotherapy	1
Age	≥60 years	2.513	0.805–7.851	0.113	5.541		1.031–29.781	0.046
	<60 years	1			1
BMI	≥25 kg/m^2	3.292	1.180–9.183	0.023	3.465		0.934–12.959	0.063
	<25 kg/m^2	1			1
Blast	≥90%	2.322	0.747–7.224	0.146	6.058		1.464–25.075	0.013
	<90%	1			1
Creatinine	≥1.4 mg/dL	2.516	0.925–6.844	0.071	5.749		1.792–18.442	0.003
	<1.4 md/dL	1			1
Gastrointestinal Leukostasis	Yes	1.567	0.562–4.370	0.391	–		–	–
	No	1
Tumor Lysis Syndrome	Yes	0.656	0.226–1.902	0.437	–		–	–
	No	1
Disseminated Intravascular Coagulation	Yes	2.005	0.738–5.444	0.172	6.541		1.822–23.490	0.004
	No	1			1
Chronic Comorbidities	Yes	0.439	0.141–1.369	0.156	–		–	–
	No	1