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 > 50,000/μl. 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 > 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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1007-1013 |
| Number of pages | 7 |
| Journal | Cancer Treatment Reports |
| Volume | 65 |
| Issue number | 11-12 |
| State | Published - 1981 |
Fingerprint
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Factors affecting survival of patients with acute myelocytic leukemia presenting with high wbc counts. / Vaughan, W. P.; Kimball, A. W.; Karp, Judith; Dragon, L. H.; Burke, P. J.
In: Cancer Treatment Reports, Vol. 65, No. 11-12, 1981, p. 1007-1013.Research output: Contribution to journal › Article
}
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, Judith
AU - Dragon, L. H.
AU - Burke, P. J.
PY - 1981
Y1 - 1981
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 > 50,000/μl. 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 > 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.
AB - Eighteen patients referred to The Johns Hopkins Oncology Center for treatment of acute myelocytic leukemia during a 2-year period had pretreatment wbc counts > 50,000/μl. 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 > 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.
UR - http://www.scopus.com/inward/record.url?scp=0019840391&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0019840391&partnerID=8YFLogxK
M3 - Article
C2 - 6945910
AN - SCOPUS:0019840391
VL - 65
SP - 1007
EP - 1013
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
SN - 0027-8874
IS - 11-12
ER -