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Abstract
Background:
Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia in its morphology as well as molecular or genetic profiles, conferring a good prognosis owing to the active roles of all-trans-retinoic acid (ATRA) and anthracyclines.
Methods:
Patients diagnosed as APL from March 1997 to April 2006 were analyzed on their clinical features, laboratory profiles, methods of treatment including remission induction, consolidation and maintenance, treatment outcomes, and treatment-related morbidity.
Results:
Chemotherapy naïve were all the 12 patients in our study consisting of 3 males and 9 females. All patients showed typical morphologic feature of APL with cytogenetic abnormality, t(15;17), and PML/RARα fusion gene was confirmed in 10 patients by FISH or PCR. The combination of cytarabine with daunorubicin (n=2) or idarubicin (n=9) was used as an induction regimen with concurrent ATRA administration. For consolidation therapy, cytarabine with anthracycline (n=4) or idarubicin monotherapy (n=8) was used with ATRA. Cytogenetic and molecular remissions were documented after induction chemotherapy (n=11) or first consolidation therapy (n=1). Maintenance therapy with ATRA was done in 11 patients. CR was obtained in 12 patients, with median remission duration of 30.5+ months (range 2 to 86+) at a median follow up duration of 33.5+ months (range 4 to 89+). One patient relapsed after completion of maintenance therapy and died of infection during reinduction chemotherapy.
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Fig. 2
ATRA syndrome. Diffuse bilateral pulmonary infiltration 20 days after ATRA administration (A, B), and disappearance after 20 days’ parenteral steroid treatment (C).
Table 1.
The schedule of chemotherapeutic regimen
Table 2.
The characteristics of patients
Table 4.
The result of chemotherapy
| No. of patients (total n=12) | |
|---|---|
| CR after induction or reinduction | 12 |
| Median month/range | |
| Follow-up duration | 33.5/(4~89) |
| CR duration | 30.5/(2~86) |
| Overall survival duration | 5～89 |
| Median survival | Not reached |
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