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Factors affecting survival of patients with acute myelocytic leukemia presenting with high wbc counts.
Cancer Treat Rep. 1981 Nov-Dec; 65(11-12):1007-13.CT

Abstract

Eighteen patients referred to The Johns Hopkins Oncology Center for treatment of acute myelocytic leukemia during a 2-year period had pretreatment wbc counts greater than 50,000/microliter. Despite immediate admission, aggressive supportive care, and rapid institution of chemotherapy, six patients died from complications of the high wbc count at presentation. The patients who died had significantly higher initial wbc counts, lower platelet counts, and lower arterial oxygen saturation; they were older, more likely to be female, and more likely to have abnormal serum urea nitrogen than the 12 patients who survived. Five of the six patients who died had experienced a delay of greater than 48 hours from diagnosis to referral, and only one of the 12 patients who survived was not promptly referred for treatment at the time of diagnosis (P = 0.004). A mathematical model, the logit of the fraction of the initial wbc count versus the logarithm of time after starting therapy, was used to describe the response of the wbc count to chemotherapy. This logit analysis reduced the data for individual patients to a linear function, permitting statistical description of the population as a whole. This statistical description makes possible the comparison of different approaches to lowering the wbc count in such patients and the correlation of rate of response of wbc count with the probability of achieving remission and with duration of remission.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

6945910

Citation

Vaughan, W P., et al. "Factors Affecting Survival of Patients With Acute Myelocytic Leukemia Presenting With High Wbc Counts." Cancer Treatment Reports, vol. 65, no. 11-12, 1981, pp. 1007-13.
Vaughan WP, Kimball AW, Karp JE, et al. Factors affecting survival of patients with acute myelocytic leukemia presenting with high wbc counts. Cancer Treat Rep. 1981;65(11-12):1007-13.
Vaughan, W. P., Kimball, A. W., Karp, J. E., Dragon, L. H., & Burke, P. J. (1981). Factors affecting survival of patients with acute myelocytic leukemia presenting with high wbc counts. Cancer Treatment Reports, 65(11-12), 1007-13.
Vaughan WP, et al. Factors Affecting Survival of Patients With Acute Myelocytic Leukemia Presenting With High Wbc Counts. Cancer Treat Rep. 1981 Nov-Dec;65(11-12):1007-13. PubMed PMID: 6945910.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors affecting survival of patients with acute myelocytic leukemia presenting with high wbc counts. AU - Vaughan,W P, AU - Kimball,A W, AU - Karp,J E, AU - Dragon,L H, AU - Burke,P J, PY - 1981/11/1/pubmed PY - 1981/11/1/medline PY - 1981/11/1/entrez SP - 1007 EP - 13 JF - Cancer treatment reports JO - Cancer Treat Rep VL - 65 IS - 11-12 N2 - Eighteen patients referred to The Johns Hopkins Oncology Center for treatment of acute myelocytic leukemia during a 2-year period had pretreatment wbc counts greater than 50,000/microliter. Despite immediate admission, aggressive supportive care, and rapid institution of chemotherapy, six patients died from complications of the high wbc count at presentation. The patients who died had significantly higher initial wbc counts, lower platelet counts, and lower arterial oxygen saturation; they were older, more likely to be female, and more likely to have abnormal serum urea nitrogen than the 12 patients who survived. Five of the six patients who died had experienced a delay of greater than 48 hours from diagnosis to referral, and only one of the 12 patients who survived was not promptly referred for treatment at the time of diagnosis (P = 0.004). A mathematical model, the logit of the fraction of the initial wbc count versus the logarithm of time after starting therapy, was used to describe the response of the wbc count to chemotherapy. This logit analysis reduced the data for individual patients to a linear function, permitting statistical description of the population as a whole. This statistical description makes possible the comparison of different approaches to lowering the wbc count in such patients and the correlation of rate of response of wbc count with the probability of achieving remission and with duration of remission. SN - 0361-5960 UR - https://www.unboundmedicine.com/medline/citation/6945910/Factors_affecting_survival_of_patients_with_acute_myelocytic_leukemia_presenting_with_high_wbc_counts_ L2 - http://www.diseaseinfosearch.org/result/203 DB - PRIME DP - Unbound Medicine ER -