Blood Res.  2013 Mar;48(1):31-34. 10.5045/br.2013.48.1.31.

Current routine practice and clinico-pathological characteristics associated with acute promyelocytic leukemia in Korea

• Ahn S
• Park JS
• Jeong SH
• Lee HW
• Park JE
• Kim MH
• Kim YS
• Lee HS
• Park TS
• You E
• Rheem I
• Park J
• Huh JY
• Kang MS
• Cho SR

• KMID: 2270723
• DOI: http://doi.org/10.5045/br.2013.48.1.31

Abstract

BACKGROUND
Acute promyelocytic leukemia (APL) can be life threatening, necessitating emergency therapy with prompt diagnosis by morphologic findings, immunophenotyping, cytogenetic analysis, or molecular studies. This study aimed to assess the current routine practices in APL and the clinico-pathologic features of APL.
METHODS
We reviewed the medical records of 48 Korean patients (25 men, 23 women; median age, 51 (20-80) years) diagnosed with APL in 5 university hospitals between March 2007 and February 2012.
RESULTS
The WBC count at diagnosis and platelet count varied from 0.4 to 81.0 (median 2.0)x10(9)/L and 2.7 to 124.0 (median 54.5)x10(9)/L, respectively. The median values for prothrombin time and activated partial thromboplastin time were 14.7 (11.3-44.1) s and 29 (24-62) s, respectively. All but 2 patients (96%) showed a fibrin/fibrinogen degradation product value of >20 microg/mL. The D-dimer median value was 5,000 (686-55,630) ng/mL. The t(15;17)(q22;q12 and PML-RARA fusion was found in all patients by chromosome analysis and/or multiplex reverse transcriptase-polymerase chain reaction (RT-PCR), with turnaround times of 8 (2-19) d and 7 (2-13) d, respectively. All patients received induction chemotherapy: all-trans retinoic acid (ATRA) alone (N=11, 26%), ATRA+idarubicin (N=25, 58%), ATRA+cytarabine (N=3, 7%), ATRA+idarubicin+cytarabine (N=4, 9%).
CONCLUSION
Since APL is a medical emergency and an accurate diagnosis is a prerequisite for prompt treatment, laboratory support to implement faster diagnostic tools to confirm the presence of PML-RARA is required.

Keyword

Acute promyelocytic leukemia; PML-RARA; Immunophenotyping; Cytogenetic analysis; All-trans retinoic acid

MeSH Terms

Cytogenetic Analysis
Emergencies
Emergency Treatment
Fibrin Fibrinogen Degradation Products
Hospitals, University
Humans
Immunophenotyping
Korea
Leukemia, Promyelocytic, Acute
Male
Medical Records
Partial Thromboplastin Time
Platelet Count
Prothrombin Time
Tretinoin
Fibrin Fibrinogen Degradation Products
Tretinoin

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