Ciftciler Rafiye, Haznedaroglu Ibrahim Celalettin, Aksu Salih, Ozcebe Osman, Sayınalp Nilgun, Malkan Umit Yavuz, Buyukasık Yahya
Hacettepe University Faculty of Medicine, Department of Hematology; Ankara, Turkey.
Dıskapı Education and Research Hospital, Department of Hematology, Ankara, Turkey.
Open Med (Wars). 2019 Sep 12;14:647-652. doi: 10.1515/med-2019-0074. eCollection 2019.
In the past, acute promyelocytic leukemia (APL) was considered as one of the most rapidly lethal form of acute myeloid leukemia (AML). The objective of this study was to assess clinical parameters affecting early death (ED) in patients with APL.
Forty-three patients with APL who were diagnosed at Hacettepe University Hospital between the years of 2005 and 2018 were evaluated.
In univariate analyses, presentation with hemorrhage, DIC or infection at diagnosis, ECOG performance score, blast percentage on bone marrow, Sanz score, leukocyte, thrombocyte, fibrinogen and LDH levels were found to be statistically significantly different between patients with ER and patients without ED. In multivariate analysis, presentation with hemorrhage, DIC or infection at diagnosis, ECOG performance score, blast percentage on bone marrow, Sanz score, leukocyte, thrombocyte, fibrinogen, and LDH levels were found to be independent factors that are related with higher rate of ED in 30 days after treatment.
Induction chemotherapy should be started as soon as possible after diagnosis of APL. Improving ED rates may become the greatest challenge for the future treatment of the diseases.
过去，急性早幼粒细胞白血病（APL）被认为是急性髓系白血病（AML）中致死速度最快的类型之一。本研究的目的是评估影响APL患者早期死亡（ED）的临床参数。
对2005年至2018年间在哈杰泰佩大学医院确诊的43例APL患者进行了评估。
在单因素分析中，发现确诊时伴有出血、弥散性血管内凝血（DIC）或感染、东部肿瘤协作组（ECOG）体能状态评分、骨髓原始细胞百分比、桑兹评分、白细胞、血小板、纤维蛋白原和乳酸脱氢酶（LDH）水平在早期死亡患者和无早期死亡患者之间存在统计学显著差异。在多因素分析中，确诊时伴有出血、DIC或感染、ECOG体能状态评分、骨髓原始细胞百分比、桑兹评分及白细胞、血小板、纤维蛋白原和LDH水平被发现是与治疗后30天内较高早期死亡率相关的独立因素。
APL确诊后应尽快开始诱导化疗。提高早期死亡率可能成为未来该疾病治疗的最大挑战。
