Analysis Of The Clinical Characteristics Of Fifty-six Patients With Acute Promyelocytic Leukemia

Objective:To approach the effect of pretherapy WBC and PLT influence the coutcome of APL patients.The theropeatic effect of different inducer remission and the main factor that cause early death.Methods:Retrospectively analyze 56 patients that final diagnosis and take inducer remission treatment in Shandong Provincial Hospital between December 2004 and December 2007.According to the treatment prescription we can dividator the 56 patients into 4 groups:the first group is 3 tpatients who use ATRA(40-60mg/d,po)until CR or 2 months.The second group is 17 patients who use ATRA(40-60mg/d,po)until CR or 2 months and As₂O₃(10mg/d ivdrip,28d as a cycle);The third group is 18 patients who use ATRA(40-60mg/d po)until CR or 2 months and DNR(40-60mg/d,3-5times).The fouth group is 18 patients who use ATRA,As₂O₃ and DNR(the same as the other groups).Analysis the CR rate,mortality,the time get CR,RAS rate to approach the therapeutical of the four groups.And approach the therapeutical of different DNR dose,one group use standard dose and the other group use individuationly until bone marrow depression.Analysis the death in the 56 patients and approach the main factors that cause early death.Results:1.High WBC group compare with the normal and low WBC group,the CR rate is lower and mortality is higher(P＜0.05),the CR rate and mortality of normal WBC group and low WBC group have no difference(P＞0.05).The CR rate of the patients that PLT count＞40×10⁹/L is higher and the mortality is lower than the patients that PLT count＜40×10⁹/L(P＜0.05).2.The CR rate,mortality,RAS rate have no differences in the four groups(P＜0.05).The first group have a longer time to get CR compared with the other three groups(P＜0.05)and there is no difference about the time to get CR among the other three group(P＞0.05)3.The group use standard dosage DNR has lower CR rate,higher mortality and longer time to get CR compare with the indiciduation dosage group(P＜0.05).4.5 patients died during the treatment.2 patients use ATRA,1 patient use ATRA and As₂O₃,1 patient use ATRA and DNR,1 patient use ATRA,As₂O₃ and DNR.The death time is 8-12days after final diagnosis.The main course is cerebral hemorrhage.5 have DIC and the PLT is 31.8±6.98×10⁹/L,the WBC i s 62±11.4×10⁹/L.Conclusion:1.The level of WBC and PLT influence the prognosis of APL.High WBC and low PLT is a factor of unfavourable prognosis.2.In inducer remission treatment,the group use ATRA lonely has longer time to get CR,but the CR rate and moratlity have no differentes.3.The group use standard dosage DNR has lower CR rate,higher mortality and longer time to get CR compare with the indiciduation dosage group.4.5 patients died during the treatment.The main cause is crerbral hemorrhage.DIC,low PLT and high WBC is the main cause of cerebral hemorrhage.