Follow-up and outcome of the twelve-year experience in adult patients with acute promyelocytic leukemia

Steffenello‐Durigon, Giovanna; Bigolin, Álisson; Moraes, Ana Carolina Rabello de; Rudolf-Oliveira, Renata Cristina Messores; Moral, Joanita Angela Gonzaga Del; Santos-Silva, Maria Cláudia

doi:10.1016/j.htct.2019.12.001

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…Similarly, in a 12-year study by Steffenello-Durigon et al in Brazil, the mean age was 34 years. Of the patients, 15.9% were categorized as low-risk, 59.1% as intermediate-risk, and 25% as high-risk, with an overall survival rate of 82.7% [ 12 ]. Abaza et al reported a mean age of 50 years with 29% high-risk patients and 71% low-risk patients and an overall survival rate of 88% [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Coagulation Abnormalities and Risk Assessment in Acute Promyelocytic Leukemia: An Experience From a Resource-Constraint Country

Thakur¹,

Anwar²,

Fatima³

et al. 2022

Cureus

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Introduction The objective of the study was to assess the impact of coagulopathy in risk-stratified acute promyelocytic leukemia (APML) patients irrespective of bleeding manifestation. Patients and methods This was a cross-sectional study design conducted at the National Institute of Blood Diseases and Bone Marrow Transplantation (NIBD & BMT) from November 2019 to December 2021. A total of 62 patients between three years to 74 years of age of either gender and treatment-naive cases of APML were included in the study. Morphological diagnosis was made on bone marrow samples, and confirmation was done by karyotyping/fluorescence in situ hybridization (FISH) and/or polymerase chain reaction (PCR). Complete blood count (CBC), prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, and fibrinogen levels were done for bleeding risk assessment. Cases other than APML and cases on treatment were excluded from the study. Results A total of 85 APML patients were registered at our institute. Among them, 62 (73%) were included in the analysis as per the inclusion criteria of the study. The median age was 32 (3-74) years, with a male predominance of 34 (55%). According to the Sanz score, 18 (29%) patients were noted to have low risk; however, 22 (35.4%) patients were found to have an intermediate-risk disease and 22 (35.4%) patients had high-risk disease. There was positive bleeding history among 44 (71%) patients, followed by fever in 28 (45%) patients. Raised PT, APTT, and D-dimer were found in 46 (74%), 38 (61%), and 52(83.8%) patients, respectively. Low fibrinogen levels were observed among 16 (26%) patients. The association of risk stratification and bleeding history with CBC and coagulation parameters was observed. Platelet count and total leucocyte count were noted to be significantly associated with risk stratification. However, there was no association observed between the rest of the parameters with risk stratification and bleeding. Conclusion The results of our study suggest that regardless of bleeding symptoms, coagulation parameters must be investigated at the time of diagnosis in patients with suspected APML, and in addition to all-trans-retinoic acid (ATRA), transfusion of fresh frozen plasma should be done. It has clinical value, and adding it to the algorithm of treatment would be beneficial to the patients in the developing world, where resources are already meager.

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Section: Discussionmentioning

confidence: 99%