Korean J Hematol.  2006 Dec;41(4):289-296. 10.5045/kjh.2006.41.4.289.

Ten-year Experience on Acute Promyelocytic Leukemia at Inha University Hospital

• Yi HG
• Lim JH
• Kim JS
• Park HJ
• Moon Y
• Lee MH
• Nahm CH
• Kim CS

• KMID: 2305216
• DOI: http://doi.org/10.5045/kjh.2006.41.4.289

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 naive 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/RAR alpha 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.
CONCLUSION
Herein is the report of ten years' experience of our hospital in the treatment of APL with favorable results as seen by high CR rate and fewer complications.

Keyword

Acute promyelocytic leukemia; All-trans-retinoic acid; Anthracycline; Treatment; Complication

MeSH Terms

Anthracyclines
Chromosome Aberrations
Cytarabine
Cytogenetics
Daunorubicin
Drug Therapy
Female
Follow-Up Studies
Humans
Idarubicin
Induction Chemotherapy
Leukemia, Myeloid, Acute
Leukemia, Promyelocytic, Acute*
Male
Polymerase Chain Reaction
Prognosis
Remission Induction
Tretinoin
Anthracyclines
Cytarabine
Daunorubicin
Idarubicin
Tretinoin

Figure

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  Fig. 1 The clinical outcome of 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).

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