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Long-term survey of outcome in acute promyelocytic leukemia: a single center experience in 340 patients

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Abstract

The aims of this study are to investigate the outcome and prognostic factors influencing long-term survival on patients with acute promyelocytic leukemia (APL). A total of 340 APL patients admitted to the Department of Hematology from January 1988 to December 2009 were enrolled in this study. All patients received all-trans retinoic acid (ATRA) and/or arsenic trioxide (ATO) with anthracycline-based induction therapy. After three courses of consolidation chemotherapy, 279 patients received 2 years of maintenance therapy. Survival analyses were carried out using the Kaplan–Meier method and the Cox regression model. In total, 288 achieved CR with the CR rate of 84.7%, and 50 patients died during induction therapy. Univariate analysis identified the following three risk factors for hemorrhagic mortality: fibrinogen level (<1.0 g/l) (P = 0.0007), initial peripheral WBC count(>4 × 109/l) (P = 0.0001), as well as the presence of coagulopathy(P < 0.0001). With a median follow-up of 49 (6–255) months, the estimated 5-year overall survival (OS) and relapse-free survival (RFS) were (89.0 ± 2.4)% and (83.7 ± 2.6)%, respectively. Cox regression analysis of the 290 patients showed initial WBC count, years of diagnosis, and the status of PML-RARα in remission seemed to be independent prognostic indicators for OS and RFS (P = 0.03, P < 0.01 and P = 0.0001, respectively). Cytogenetics in addition to above three variables remained significant for RFS (P = 0.01). Our retrospective observations suggest that the combination of ATRA and/or ATO with anthracycline-based therapy may have useful implications in the perspective of long-term prognosis for adult APL.

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Authors and Affiliations

  1. The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People’s Republic of China

    Yue-Jun Liu, Jian-Ying Liang, Hui-Ying Qiu, Zheng-Ming Jin, Xiao-Wen Tang, Cheng-Cheng Fu & Xiao Ma

  2. Department of Hematology, First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, 215006, Suzhou, Jiangsu, People’s Republic of China

    De-Pei Wu

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  1. Yue-Jun Liu
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Liu, YJ., Wu, DP., Liang, JY. et al. Long-term survey of outcome in acute promyelocytic leukemia: a single center experience in 340 patients. Med Oncol 28 (Suppl 1), 513–521 (2011). https://doi.org/10.1007/s12032-010-9733-7

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  • DOI: https://doi.org/10.1007/s12032-010-9733-7

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