Clinical Observation Of 54 Patients With Acute Promyelocytic Leukemia

Objective In a retrospective study, the clinical information of acute promyelocytic leukemia was analyzed. All the patients were in the Hematology Department, the first affiliated hospital of Guangxi Medical University. The therapeutic effect of them was evaluated.Method Patients'elemental information was searched, who were newly diagnosed in this hospital from June 2005 to December 2008. The necessary data was extracted from the medical records in the medical records room. The following up was made via telephone to confirm the condition of the patients. Data was analyzed to calculate complete remission rate, early death rate, overall survival (OS) and relapse free survival (RFS) by SPSS 10.0.Results1.28 of 54 patients were present with pancytopenia at diagnosis.36 patients' immunophenotype was tested. All the patients were with high expression of the CD33, and low expression or even absent of the HLA-DR.35 patients were with low expression of CD34 and only one patient with high expression of it.2. Of the 54 patients,50 patients achieved CR after induction. The CR rate was 92.6%.4 patients died during the early induction, and all died of bleeding.3. Of the 50 patients,48 patients could be followed up by telephone.45 of them were alive with no relapse and 2 of them lost. The median follow-up time was 35.5 months (range,1～56 months).4. ALL the patients'predicted 3-year OS was 88%, and the CR patients' predicted 3-year RFS was 93.1%(90.9% in the high risk group).5.33 patients used ATRA+chemotherapy for induction while 19 patients used ATRA+ATO+chemotherapy for induction. There was no statistically difference among the two groups in CR rate and the time to obtain CR.6.14 patients received 2～5 circles of consolidation and 32 patients received 6 or more circles of consolidation. The OS and RFS showed no statistically difference among the two groups.Conclusion1. When patients present with pancytopenia and/or high expression of the CD33, and low expression or even absent of the CD34 and HLA-DR at admission, extra attention should be paid because APL is highly suspected in these patients.2. Bleeding remains the crucial reason for the early death in APL patients.3. For the APL patients, especially for the low or intermediate risk group patients,2-5 circles consolidation, may obtain a very good long-term survival.4. For the high-risk group patients, add 1-2 circles ATO to patients' anthracycline based consolidation, may obtain a better long-term survival.