Early death in acute leukemia in children
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Early death in childhood acute leukemia is rare, but extremely high white blood cell (WBC) counts at diagnosis significantly increase this risk. This finding highlights a critical factor for monitoring pediatric leukemia patients.
Area of Science:
- Pediatric Oncology
- Hematology
Background:
- Childhood acute leukemia therapy has advanced, reducing early mortality.
- A subset of patients with extremely elevated white blood cell (WBC) counts at diagnosis face a higher risk of early death.
Purpose of the Study:
- To retrospectively assess the incidence and outcomes of early death in pediatric acute leukemia.
- To evaluate the specific risk associated with extremely high WBC counts at diagnosis.
Main Methods:
- Retrospective review of pediatric acute leukemia cases over a 10-year period.
- Analysis of early death rates based on initial WBC counts at diagnosis.
Main Results:
- Overall early death rate was 4.9% (9 out of 185 cases).
- Patients with WBC < 100,000/mm3 had a 2.5% early death rate (4/160).
- Patients with WBC > 100,000/mm3 had a significantly higher early death rate of 20% (5/25), p < 0.001.
Conclusions:
- Extremely elevated WBC counts at diagnosis are a significant risk factor for early death in pediatric acute leukemia.
- Identifying these high-risk patients is crucial for targeted monitoring and intervention strategies.
Abstract:
Therapy for acute leukemia in children has improved dramatically in recent years so that early death is rare. A subset of patients with extreme elevation of the WBC at diagnosis have been noted to have a higher rate of early death. We reviewed our experience with acute leukemia in children retrospectively over a 10 year period to assess the incidence and outcome of this problem. Nine early deaths occurred in a total of 185 cases (4.9%). One hundred and sixty patients presented with WBC less than 100,000/mm3 at diagnosis and four (2.5%) early deaths occurred. Twenty-five patients presented with WBC greater than 100,000/mm3 at diagnosis and five (20%) early deaths occurred (p less than 0.001). While early death in acute leukemia in children is uncommon (4.9%), patients with extremely elevated WBC at diagnosis have a significantly higher risk of early death.