We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The evaluation of risk factors leading to early deaths in patients with acute promyelocytic leukemia: a retrospective study.
- Authors
Baysal, Mehmet; Gürsoy, Vildan; Hunutlu, Fazil Cagri; Erkan, Buket; Demirci, Ufuk; Bas, Volkan; Gulsaran, Sedanur Karaman; Pinar, Ibrahim Ethem; Ersal, Tuba; Kirkizlar, Tugcan Alp; Atli, Emine Ikbal; Kirkizlar, Hakki Onur; Ümit, Elif G; Gürkan, Hakan; Ozkocaman, Vildan; Ozkalemkas, Fahir; Demir, Ahmet Muzaffer; Ali, Ridvan
- Abstract
Acute promyelocytic leukemia (APL) differs from other forms of acute myeloid leukemia (AML), including coagulopathy, hemorrhage, disseminated intravascular coagulation (DIC), and treatment success with all-trans retinoic acid (ATRA). Despite ATRA, early deaths (ED) are still common in APL. Here, we evaluated factors associated with ED and applicability of scoring systems used to diagnose DIC. Ninety-one APL patients (55 females, 36 males, and median age 40 years) were included. ED was defined as deaths attributable to any cause between day of diagnosis and following 30th day. DIC was assessed based on DIC scoring system released by the International Society of Thrombosis and Hemostasis (ISTH) and Chinese Diagnostic Scoring System (CDSS). Patients' median follow-up time was 49.2 months, and ED developed in 14 (15.4% of) cases. Patients succumbing to ED had higher levels of the Eastern Cooperative Oncology Group Performance Status (ECOG PS), lactate dehydrogenase (LDH), and ISTH DIC, and lower fibrinogen levels (p <0.05). In multivariate Cox regression analysis, age >55 and ECOG PS ≥2 rates were revealed to be associated with ED. Based on ISTH and CDSS scores, DIC was reported in 47.3 and 58.2% of the patients, respectively. Despite advances in APL, ED is still a major obstacle. Besides the prompt recognition and correction of coagulopathy, those at high ED risk are recommended to be detected rapidly. Implementation of local treatment plans and creating awareness should be achieved in hematological centers. Common utilization of ATRA and arsenic trioxide (ATO) may be beneficial to overcome ED and coagulopathy in APL patients.
- Subjects
ACUTE promyelocytic leukemia; EARLY death; DISSEMINATED intravascular coagulation; RISK assessment; ACUTE myeloid leukemia
- Publication
Annals of Hematology, 2022, Vol 101, Issue 5, p1049
- ISSN
0939-5555
- Publication type
Article
- DOI
10.1007/s00277-022-04798-8