Effectiveness of leukapheresis on early survival in acute myeloid leukemia: An observational propensity score matching cohort study

Background: The association between leukapheresis (LK) as a treatment option for hyperleukocytosis (HL) in patients with acute myeloid leukemia (AML) remains controversial. Methods: Data were extracted from the electronic medical record for 2801 patients with AML between April 2009 and December 2019. LK was performed when the leukocyte count was ≥100 × 10⁹/L at the time initial bone marrow examination. Results: A comparison between the patients with HL in the non-LK (n = 1579) and LK (n = 208) groups revealed survival probabilities (%) of 93.2% and 90.4% (P =.130) for day 30 (D30), 85.4% and 84.2% (P =.196) for D60, and 83.6% and 80.8% (P =.258) for D90, respectively. After propensity score matching, a comparison between the patients with HL in the non-LK (n = 192) and LK (n = 192) groups revealed survival probabilities (%) of 83.9% and 91.2% (P =.030) for D30, 75.0% and 84.9% (P =.015) for day 60 (D60), and 62.4% and 81.3% (P =.034) for day 90 (D90), respectively. After D150, the observed effect of LK appeared to be mitigated without a survival benefit. Discussion: LK was associated with improved early survival outcomes at D30, D60, and D90 among patients with AML exhibiting HL. Thus, it may be considered a treatment option for reducing cell mass in such patients.