Department of Hematology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Immunopharmacol Immunotoxicol. 2020 Feb;42(1):17-21. doi: 10.1080/08923973.2019.1692865. Epub 2019 Nov 19.
Recently, acute promyelocytic leukemia (APL) has shifted from the most hazardous to the best curable type of acute myeloid leukemia. Anthracyclines, all-trans retinoic acid (ATRA) and arsenic derivatives are the most important developments for the treatment of APL. ATRA promotes the terminal differentiation of malignant promyelocytes to mature neutrophils. We aimed to compare platelet and neutrophil recovery time after induction chemotherapy in patients with acute myeloid leukemia (AML) and APL. Two hundred and fifteen patients with AML and APL, who were diagnosed and treated in our tertiary care center between the years of 2001 and 2018 were evaluated. One hundred and eighty one AML patients (84.2%) and 34 (15.8%) APL patients were included in this study. The time between neutrophil nadir after induction chemotherapy and neutrophil recovery was longer in APL patients than in AML patients [30.5 (4-52) vs. 20 (5-58), < 0.001]. The time between platelet nadir after induction chemotherapy and platelet recovery was longer in APL patients than in AML patients [21.5 (4-42) vs. 17 (4-45), = 0.02]. Neutrophil and platelet recovery times were longer in APL patients than in AML patients in our present study. In 60 days, mortality rate was higher in APL patients than AML patients. Non-relapse mortality (NRM) rate was similar between two groups. There was a significant difference between two groups in terms of NRM causes. Platelet and neutrophil recovery time is very important because infection is the most important cause of NRM.
近年来，急性早幼粒细胞白血病（APL）已从最危险的急性髓系白血病转变为最可治愈的类型。蒽环类药物、全反式维甲酸（ATRA）和砷衍生物是治疗 APL 的最重要进展。ATRA 可促进恶性早幼粒细胞向成熟中性粒细胞的终末分化。我们旨在比较急性髓系白血病（AML）和 APL 患者诱导化疗后血小板和中性粒细胞恢复时间。对 2001 年至 2018 年在我们的三级护理中心诊断和治疗的 215 例 AML 和 APL 患者进行了评估。本研究纳入了 181 例 AML 患者（84.2%）和 34 例 APL 患者（15.8%）。APL 患者诱导化疗后中性粒细胞最低点至中性粒细胞恢复的时间长于 AML 患者[30.5（4-52）比 20（5-58），<0.001]。APL 患者诱导化疗后血小板最低点至血小板恢复的时间长于 AML 患者[21.5（4-42）比 17（4-45），=0.02]。与 AML 患者相比，APL 患者的中性粒细胞和血小板恢复时间更长。在 60 天内，APL 患者的死亡率高于 AML 患者。两组之间非复发死亡率（NRM）相似。两组之间的 NRM 原因存在显著差异。血小板和中性粒细胞恢复时间非常重要，因为感染是 NRM 的最重要原因。
