Distribution of leukapheresis in two risk groups of the ED_d7 Score.

<p>The group of patients undergoing leukapheresis contained more patients classified as HiR compared to the group of patients that received chemotherapy only.</p><p>Abbreviations: HiR, high risk group according to the early death day 7 score; LowR, low risk group according to the early death day 7 score.</p

A: binary logistic regression for Death within 7 days (ED_d7). B: binary logistic regression for Death within 7 days (ED_d7).

<p><b>9A</b>: Therapeutic leukapheresis did not impact on the early death rate when the early death score was introduced as a continuous variable into the binary logistic regression. <b>9B</b>: Therapeutic leukapheresis might lower the risk of early death in patients belonging to the LowR d7 group. Abbreviations: CL, confidence limit; n, number; OR, Odds Ratio.</p

Patient characteristics of all intensively treated patients with WBC≥100 G/l.

<p>Patients with hyperleukocytosis had a reduced ECOG performance status and highly elevated WBC, LDH level and blast counts.</p><p>Abbreviations: BM blasts; bone marrow blasts; EOCG, Eastern Cooperative Group; LDH, lactase dehydrogenase; PB blasts; blasts in the peripheral blood; WBC, white blood count.</p><p>*one patient with an AML M5A showed 14% of myeloblasts in the peripheral blood, not accounting for the 59% of monoblasts in AML M5.</p

Efficacy of reduction of WBC with chemotherapy only and chemotherapy combined with leukapheresis.

<p>Abbreviations: WBC, white blood count.</p

Morphologic, cytogenetic and molecular characteristics of patients with WBC≥100 G/l.

<p>Hyperleukocytotic patients commonly had AML FAB types M4/M5 or ELN favorable or intermediate-I risk.</p><p>Abbreviations: FAB, French-American-British classification of AML; ELN, European Leukemia Net classification of AML; <i>FLT</i>3-ITD, internal tandem duplication of the <i>FLT</i>3 gene; <i>FLT</i>3-TKD, point mutation at D835 in the <i>FLT</i>3-tyrosine kinase domain of the <i>FLT</i>3 gene; <i>MLL</i>-PTD, partial tandem duplication of the <i>MLL</i> gene; n, number; <i>NPM</i>1, nucleophosmin1.</p

Complications within 7 days of treatment.

<p>There was a trend to more bleeding events and thromboembolic events within the patients receiving leukapheresis and chemotherapy.</p><p>*exact time point of the first manifestation splenic infarction is not clear; it was diagnosed in a CT scan performed after leukapheresis.</p><p>Abbreviations: LA, leukapheresis.</p

Univariate logistic regression for Death within 7 days (ED_d7).

<p>In the entire patient cohort, the effect of leukapheresis was not significant in the context of the early death score.</p><p>Abbreviations: CL, confidence limit; HiR, high risk group according to the early death day 7 score; LowR, low risk group according to the early death day 7 score; n, number; OR, Odds Ratio.</p

Clinical manifestations of hyperleukocytosis/leukostasis in all patients, patients with therapeutic leukapheresis plus chemotherapy and patients with chemotherapy only.

<p>Patients receiving leukapheresis and chemotherapy showed significantly more clinical symptoms of leucostasis and a deregulated coagulation compared to the patients receiving chemotherapy only. This reflects the policy of leukapheresis in our hospital, since only patients with signs of leukocytosis underwent leukapheresis.</p><p>Abbreviations: CPAP, continuous positive airway pressure; HD, hemodialysis; HF, hemofiltration; ITN, intubaton; LA, leukapheresis; PTT, partial thromboplastin time.</p

Survival in the first 35 days according to the ED_d7 Score.

<p>Median OS was 8.8 months (95% CI: 5.4–12.3 months) in patients with a LowR score (<−2.81) and 0.2 months (95% CI: 0.03–0.3 months) in patients with a HiR score (≥−2.81). Abbreviations: CI, confidence interval; HR, Hazard Ratio; OR_d35, Odds ratio for death until (≤) day 35; OS, Overall survival.</p

Outcome in all patients, patients with therapeutic leukapheresis plus chemotherapy and patients with chemotherapy only.

<p>Patients that were treated with leukapheresis and chemotherapy had a higher death rate in the first 24 hours and first 7 days compared to patients receiving chemotherapy only. Reasons for lack of evaluation for remission status in 5 patients were a) no diagnostic bone marrow biopsy due to patient desire (n = 1) b) loss of follow-up (n = 1), end of follow- up (n = 1), no complete induction therapy (n = 2).</p><p>Abbreviations: LA, leukapheresis, n, number.</p