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Related Concept Videos

Drug Toxicity: Risk factors01:24

Drug Toxicity: Risk factors

Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...

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Identifying Risk Factors and Outcome for CNS Involvement in AML.

Jack T Seki1, Georgina S Daher-Reyes2, Eshetu G Atenafu3

  • 1Leslie Dan Faculty of Pharmacy, Department of Medical Oncology Hematology, University of Toronto, 144 College St., Toronto, Ontario M5S 3M2, Canada.

Clinical Lymphoma, Myeloma & Leukemia
|July 31, 2025
PubMed
Summary
This summary is machine-generated.

Central nervous system (CNS) infiltration in acute myeloid leukemia (AML) is serious. High white blood cell counts (WBC ≥40), elevated LDH, NPM1 mutation, or 11q23 abnormality identify high-risk patients for CNS+ screening.

Keywords:
Acute myeloid leukemiaCNS infiltrationMolecular profileNGSRisk factors and outcomes

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Area of Science:

  • Hematology
  • Oncology
  • Molecular Biology

Background:

  • Central nervous system (CNS) infiltration is a severe complication in acute myeloid leukemia (AML).
  • Molecular factors predicting CNS disease in AML are not well-defined.

Purpose of the Study:

  • To identify molecular and clinical characteristics associated with CNS infiltration in AML patients.
  • To evaluate the impact of these factors on patient outcomes.

Main Methods:

  • Retrospective analysis of 259 AML patients undergoing lumbar puncture (LP) and intrathecal (IT) chemotherapy.
  • Next-generation sequencing (NGS) for mutation analysis.
  • Univariate and multivariable analyses to determine associations with CNS+ disease.

Main Results:

  • 31 patients (11.97%) had confirmed CNS+ disease.
  • NPM1 and FLT3 mutations were more common in CNS+ patients.
  • Independent predictors for CNS+ included high white blood cell (WBC) counts (≥30 or ≥40 × 10⁹/L), elevated lactate dehydrogenase (LDH) combined with NPM1 mutation, and 11q23 abnormality.

Conclusions:

  • Routine screening LP and prophylactic IT chemotherapy are recommended for high-risk AML patients (defined by WBC, LDH, NPM1, or 11q23 status).
  • This approach may help prevent CNS+ disease and relapse.
  • Further prospective trials are needed to validate these findings.