Hyperleukocytosis in adult XXXX : impact on remission rate and duration, and survival.

@entity1 @entity548 @entity146 @entity5 @entity6922 @entity3052 @entity204
The clinical courses of 353 @entity1 with @entity3052 ( @entity3052 ) treated between 1971 and 1982 at the Baltimore @entity5 Research Program (BCRP) of the National @entity5 Institute were reviewed and examined for the impact of presenting WBC count on the initial course and overall outcome of these @entity1 . Group A (WBC greater than 100,000/microL) had significantly more @entity204 during the first week of therapy than did group C (WBC less than 50,000/microL) (P = .0003). CNS @entity548 was responsible for a significantly greater number of @entity204 in group A compared with group C (P less than .004). The group B (WBC 50,000 to 100,000/microL) death rate was intermediate. These findings are consistent with other reports of complications of @entity6922 . Rapid intervention with antileukemic therapy and cranial irradiation may have decreased the risk of CNS @entity548 in group A. If early @entity204 are removed from analysis, the complete remission rate among @entity1 groups is not significantly different (group A, 59%; group B, 68%; group C, 65%). However, further analyses of @entity1 achieving remission demonstrate significant differences among @entity1 groups based on presenting WBC count. The median complete remission duration of @entity1 in group A (4.2 months) is shorter than that of @entity1 in group B (8.0 months) or C (8.0 months), P = .07. In addition, remission duration has improved with modern @entity146 antileukemic therapy in groups B (median before 1977, 7.0 months; after 1977, 22.0 + months) and C (before 1977, 6.0 months; after 1977, 16.0 + months). No such improvement has occurred in group A, in which the median duration of remission was 4.2 months before and after 1977. The same findings are demonstrated in an analysis of survival, with improvement occurring only in groups B (median before 1977, 16.5 months; after 1977, 26.0 + months) and C (before 1977, 13.5 months; after 1977, 24.0 + months). Long-term follow-up (minimum of 4 years) of these @entity1 has allowed an analysis of the effect of presenting WBC count on the overall outcome of adult @entity1 with @entity3052 .
