<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Background.</bold> After the inclusion of all-trans retinoic acid (ATRA) into the treatment of Acute Promyelocytic leukemia (APL), a notable improvement concerning the survival rates of patients with APL has been observed. However, the population-based studies demonstrated that there was no marked improvement in the survival of patients after the 2000s. We aim to describe the clinical response and prognosis of adult patients diagnosed with APL and examine the change in these outcomes by the time period of diagnosis.<bold>Methods.</bold> We retrospectively reviewed thirty-six unselected APL patients who were diagnosed between September 2003 and February 2016.<bold>Results.</bold> The probability of survival at two years was 58%, while disease-free survival (DFS) was 87%. The overall early death (ED) rate was 33% and remain stable over time [42% in 2003–2009 vs. 24% in 2010–2016 (p=.20)]. In addition, the 2-year overall survival (OS) rates were 47% in 2003–2009 and 70% in 2010–2016 (p=.29), and no differences were noted. Univariate analyses showed possible predictors of poor OS were defined as leukocytosis (≥10x109/L), high Sanz score, hemorrhage, infection, disseminated intravascular coagulopathy (DIC) at presentation and microgranular morphologic subtype.<bold>Conclusions.</bold> This study shows that long-term survival remains low in APL patients, particularly related to a high ED rate. Initiatives to reduce ED are exceedingly substantial for improving the survival in APL.</abstract>

Background. After the inclusion of all-trans retinoic acid (ATRA) into the treatment of Acute Promyelocytic leukemia (APL), a notable improvement concerning the survival rates of patients with APL has been observed. However, the population-based studies demonstrated that there was no marked improvement in the survival of patients after the 2000s. We aim to describe the clinical response and prognosis of adult patients diagnosed with APL and examine the change in these outcomes by the time period of diagnosis.Methods. We retrospectively reviewed thirty-six unselected APL patients who were diagnosed between September 2003 and February 2016.Results. The probability of survival at two years was 58%, while disease-free survival (DFS) was 87%. The overall early death (ED) rate was 33% and remain stable over time [42% in 2003–2009 vs. 24% in 2010–2016 (p=.20)]. In addition, the 2-year overall survival (OS) rates were 47% in 2003–2009 and 70% in 2010–2016 (p=.29), and no differences were noted. Univariate analyses showed possible predictors of poor OS were defined as leukocytosis (≥10x109/L), high Sanz score, hemorrhage, infection, disseminated intravascular coagulopathy (DIC) at presentation and microgranular morphologic subtype.Conclusions. This study shows that long-term survival remains low in APL patients, particularly related to a high ED rate. Initiatives to reduce ED are exceedingly substantial for improving the survival in APL.

Real-life outcomes of unselected acute promyelocytic leukemia patients: a single-center 14-year experience

Romanian Journal of Internal Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Background. After the inclusion of all-trans retinoic acid (ATRA) into the treatment of Acute Promyelocytic leukemia (APL), a notable improvement concerning...

Real-life outcomes of unselected acute promyelocytic leukemia patients: a single-center 14-year experience

Published Online: Aug 10, 2020

Page range: 138 - 145

Received: Feb 10, 2020

DOI: https://doi.org/10.2478/rjim-2020-0011

Keywords
acute promyelocytic leukemia, early death, overall survival, real-life outcomes, predictors

© 2020 Omer Faruk Akcay et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Real-life outcomes of unselected acute promyelocytic leukemia patients: a single-center 14-year experience

Published Online: Aug 10, 2020

Page range: 138 - 145

Received: Feb 10, 2020

DOI: https://doi.org/10.2478/rjim-2020-0011

Keywordsacute promyelocytic leukemia, early death, overall survival, real-life outcomes, predictors

© 2020 Omer Faruk Akcay et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
acute promyelocytic leukemia, early death, overall survival, real-life outcomes, predictors