Bajpai J, Sharma A, Kumar L, Dabkara D, Raina V, Kochupillai V, Kumar R
Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India.
Indian J Cancer. 2011 Jul-Sep;48(3):316-22. doi: 10.4103/0019-509X.84938.
There are very limited data reported about acute promyelocytic leukemia (APL) from developing countries. We reviewed the clinical course and treatment outcome of APL patients treated at our center.
Between January 1997 and December 2007, 33 patients with APL received induction therapy using ATRA + daunorubicin (n = 26), As = 26), As2O3 (n = 4) or daunorubicin + cytosar ( n = 3).
Median age was 30 years with a male to female ratio of 1.68. Twenty seven patients (82%) achieved CR. Complications during induction therapy were febrile neutropenia (33%), ATRA syndrome (30%), bleeding (58%), and diarrhea in (6%) patients. During induction and follow up, 8 (24.24%) patients died, 6 (18.18%) during induction, 1 (3%) during maintenance, and 1 (3%) after relapse. Median OS is 128 months while median EFS is 61 months. Four patients relapsed at a median time of 61 months. At the time of censoring, 25 patients were alive at a median follow up of 13 months (range 0.6 -127 months); 21 in CR1, 3 in CR2, 1 in CR3. Comparisons among the risk groups (CR and relapse rate and survival statistics) were not statistically significant.
APL is a highly curable malignancy. Our results confirm the findings of the published literature from larger cooperative studies from the West. We may further improve outcome with quicker diagnosis and more efficient supportive care system.
来自发展中国家的急性早幼粒细胞白血病（APL）相关报道数据非常有限。我们回顾了在我们中心接受治疗的APL患者的临床病程及治疗结果。
1997年1月至2007年12月期间，33例APL患者接受了诱导治疗，使用全反式维甲酸（ATRA）+柔红霉素（n = 26）、三氧化二砷（As2O3，n = 4）或柔红霉素+阿糖胞苷（n = 3）。
中位年龄为30岁，男女比例为1.68。27例患者（82%）达到完全缓解（CR）。诱导治疗期间的并发症包括发热性中性粒细胞减少（33%）、ATRA综合征（30%）、出血（58%）以及腹泻（6%）。在诱导治疗及随访期间，8例（24.24%）患者死亡，诱导治疗期间死亡6例（18.18%），维持治疗期间死亡1例（3%），复发后死亡1例（3%）。中位总生存期（OS）为128个月，而中位无事件生存期（EFS）为61个月。4例患者复发，中位复发时间为61个月。在审查时，25例患者存活，中位随访时间为13个月（范围0.6 - 127个月）；21例处于首次完全缓解（CR1），3例处于第二次完全缓解（CR2），1例处于第三次完全缓解（CR3）。风险组之间的比较（CR和复发率以及生存统计）无统计学意义。
APL是一种高度可治愈的恶性肿瘤。我们的结果证实了西方大型合作研究发表文献中的发现。我们可以通过更快的诊断和更有效的支持治疗系统进一步改善治疗结果。
