J Korean Med Sci.  1994 Dec;9(6):437-443. 10.3346/jkms.1994.9.6.437.

Acute promyelocytic leukemia is a distinct subset of acute myelocytic leukemia with unique clinicopathologic characteristics including longer duration of relapse free survival: experience in 13 cases

• Lee KH
• Kim DH
• Lee JS
• Suh CW
• Kim SW
• Kim SB
• Lee JH
• Doh BS
• Chi HS
• Lee MS

• KMID: 644833
• DOI: http://doi.org/10.3346/jkms.1994.9.6.437

Abstract

Acute promyelocytic leukemia(APL) is a subtype of acute myelocytic leukemia(AML) associated with unique features such as the presence of atypical promyelocytes and bleeding tendency due to disseminated intravascular coagulation(DIC). In a retrospective study, we analyzed 96 cases of AML seen at our hospital between June, 1989 and December 1993. Thirteen cases of APL(14%) were identified and their clinicopathologic characteristics were analyzed. The 86 cases of other types of AML served as controls. The distinct clinicopathologic features of APL as contrasted to other types of AML included younger age of patients, shorter duration of symptom before diagnosis, higher level of albumin at presentation, and a higher proportion of patients having coagulation abnormalities (75 vs. 25%). Bone marrow cellularity was higher in APL when compared to other types of AML (100 vs. 90%, P = 0.013). Of 13 patients with APL, 4 died of bleeding/sepsis between days 2 to 4 after admission. Seven of 9 patients who received induction therapy achieved complete remission(CR). CR rate in APL was similar to other types of AML (78 vs. 64%, P = 0.743). Five of seven patients who achieved CR remain in continuous CR at 9+ to 42+ months. CR duration is significantly longer in APL when compared to other types of AML (P = 0.029). In conclusion, this study showed that APL is a distinct entity among subtypes of AML with clinically significant bleeding tendency and rapidly fatal course if untreated. With appropriate antileukemic therapy, CR can be achieved in the majority of patients and the patients show a longer duration of CR when compared to other types of AML.

Keyword

Acute promyelocytic leukemia

MeSH Terms

Acute Disease
Adolescent
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Blood Cell Count
Bone Marrow/pathology
Comparative Study
Disease-Free Survival
Disseminated Intravascular Coagulation/etiology
Female
Hemorrhagic Disorders/etiology
Human
Immunophenotyping
Korea/epidemiology
Korea/epidemiology
Leukemia, Myeloid/*classification/mortality/pathology
Leukemia, Promyelocytic, Acute/*classification/complications/drug therapy/mortality/pathology
Male
Middle Age
Remission Induction
Retrospective Studies
Serum Albumin/analysis