Hyperleukocytosis in Pediatric Patients with Acute Lymphoblastic Leukemia: Demographic and Clinical Characteristics
Małgorzata Monika Mitura-Lesiuk1, Maciej Dubaj2, Aleksandra Dembowska2
1Department of Paediatric Haematology, Oncology, and Transplantology, Medical University of Lublin, 20-093 Lublin, Poland.
Insights
Hyperleukocytosis in childhood acute lymphoblastic leukemia (ALL) is linked to older boys and T-ALL, presenting higher mortality and infection risks. This condition significantly impacts ALL prognosis and clinical outcomes.
Area of Science:
- Pediatric Oncology
- Hematology
- Leukocyte Biology
Background:
- Hyperleukocytosis, defined as leukocyte count >50,000/mm³.
- Occurs in nearly 20% of pediatric acute lymphoblastic leukemia (ALL) cases.
- Identified as an unfavorable prognostic factor in ALL.
Purpose of the Study:
- To describe demographic and clinical features of pediatric ALL patients with hyperleukocytosis.
- To investigate the relationship between hyperleukocytosis and leukocyte count.
- To assess the prognostic implications of hyperleukocytosis in pediatric ALL.
Main Methods:
- Retrospective analysis of medical data.
- Study population: pediatric patients with ALL diagnosed and treated between 2017-2024.
- Inclusion criteria: diagnosis of ALL and available medical data.
Main Results:
- 10.3% of 97 pediatric ALL patients exhibited hyperleukocytosis.
- Hyperleukocytosis was more prevalent in older boys with T-ALL.
- Associated with higher mortality, petechiae, altered thrombocyte/neutrophil counts, elevated LDH, and increased infection incidence.
Conclusions:
- Hyperleukocytosis is a significant clinical and prognostic factor in pediatric ALL.
- Early identification and management of hyperleukocytosis are crucial.
- Further research into managing hyperleukocytosis in ALL is warranted.
Abstract:
Background: Hyperleukocytosis, defined as a total leukocyte count of more than 50,000/mm3 leukocytes, occurs in almost one in five children with acute lymphoblastic leukemia (ALL). It represents an unfavorable prognostic factor in this disease. The aim of the following study was to describe demographic and clinical features in patients with hyperleukocytosis and their relationship with leukocyte count. Methods: We retrospectively analyzed the available medical data of patients with ALL diagnosed and treated at the University Children's Hospital in Lublin between 2017 and 2024. Results: Of the 97 patients, 10 (10.3%) had hyperleukocytosis. They were significantly more likely to be older boys diagnosed with T-ALL. The group with hyperleukocytosis had a higher mortality rate. The presence of hyperleukocytosis also correlated with the presence of petechiae, thrombocyte and neutrophil counts, and LDH activity. Patients with hyperleukocytosis also experienced a higher incidence of infections as a complication of therapy as leukocyte counts increased. Conclusions: Hyperleukocytosis, although rare, is an important factor in the course of ALL, both clinically and prognostically.
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