Long-term survival analysis in 170 cases of acute promyelocytic leukemia.
- Author:
Xin LI
1
;
Yao-Zhong ZHAO
;
Zeng-Jun LI
;
Yun-Tao LI
;
Yan LI
;
Chang-Chun WAN
;
Qiao-Chuan LI
;
Shu-Hui DENG
;
Ren-Chi YANG
;
Ming-Zhe HAN
;
Lu-Gui QIU
Author Information
1. Institute of Hematology, Hematological Hospital, Union Medical University of China, The Chinese Academy of Medical Sciences, Tianjin 300020, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Aged;
Antineoplastic Combined Chemotherapy Protocols;
therapeutic use;
Arsenicals;
administration & dosage;
Child;
Female;
Follow-Up Studies;
Humans;
Leukemia, Promyelocytic, Acute;
drug therapy;
mortality;
Male;
Middle Aged;
Oncogene Proteins, Fusion;
metabolism;
Oxides;
administration & dosage;
Prognosis;
Proportional Hazards Models;
Remission Induction;
Retrospective Studies;
Survival Analysis;
Survival Rate;
Tretinoin;
administration & dosage
- From:
Journal of Experimental Hematology
2006;14(3):437-441
- CountryChina
- Language:Chinese
-
Abstract:
This study was aimed to investigate various factors influencing long-term survival in patients with acute promyelocytic leukemia. A single institutional retrospective study with long-term follow-up was performed to better define the prognostic factors and a rationale for the use of ATRA, chemotherapy, and As(2)O(3) in the treatment of newly diagnosed APL patients. Newly diagnosed patients with APL entering complete remission (CR) were followed up for 6 to 185 months (n = 170) from January 1990 to December 2004. Univariate and multivariate analysis of 8 potential factors influencing survival and prognosis were carried out with Log-Rank and Cox regression method, including sex, age, initial WBC count, the level of lactic hydrogenase (LDH), first induction regimen, time from induction therapy to CR, post-remission therapy, negative or positive rate of PML-RAR alpha and follow-up of reverse transcription-polymerase chain reaction (RT-PCR). The results showed that the estimated 5-year overall survival (OS) and relapse-free survival (RFS) were 80.9% +/- 4.0% and 71.0% +/- 4.0% respectively. The 23 patients relapsed at the median time of 15 months (6 - 70) after CR. Univariate analysis revealed that initial WBC count, first induction regimen, time from induction therapy to CR, type of post-remission therapy and persistent negative RT-PCR in remission were important prognostic factors for long-term survival. Multivariate study demonstrated that only type of post-remission therapy was associated with RFS and OS. It is concluded that the post-remission treatment combining ATRA, As(2)O(3) and chemotherapy would significantly improve the long-term survival of APL patients entering CR(1).
