No abstract available.
Leukemia, Large Granular Lymphocytic*

INTRODUCTIONAcute promyelocytic leukaemia (APL) is a distinct clinical and biological subtype of acute myeloid leukaemia. APL is notorious for causing early death during induction therapy, resulting in induction failure. The aim of our study was to report the clinical characteristics, outcome and early induction deaths with regard to patients with APL seen at our hospital.

METHODSThis was a retrospective study carried out at Aga Khan University Hospital, Karachi, Pakistan. Patients aged > 15 years diagnosed with APL within the period September 2007-September 2012 were included in the study.

RESULTSWithin the study period, 26 patients were diagnosed with APL based on morphology and the detection of t(15;17)(q24.1;q21.1) and promyelocytic leukaemia-retinoic acid receptor alpha (PML-RARA). The male to female ratio was 1:1. The median age of the patients was 41 (range 16-72) years. In all, there were 13 (50.0%) high-risk patients, and early induction death rate was 61.5%. Causes of early induction deaths (n = 16) included haemorrhage in 7 (43.8%) patients, differentiation (ATRA) syndrome in 7 (43.8%) and infection in 2 (12.5%). The survival rate among patients who survived the early period was 70% at 42 months. The relapse rate was 30%.

CONCLUSIONEarly induction death rate was very high in patients with APL. The most common cause of early induction death in our study was haemorrhage. Outcome among patients with APL was found to be better among those who survived the initial period.

Adolescent ; Adult ; Aged ; Female ; Humans ; Leukemia, Promyelocytic, Acute ; diagnosis ; therapy ; Male ; Middle Aged ; Pakistan ; Recurrence ; Retrospective Studies ; Tertiary Care Centers ; Time Factors ; Translocation, Genetic ; Treatment Outcome ; Young Adult

The significance of patient-reported outcomes (PROs) is increasingly being acknowledged and quality of life (QOL) has become an integral element of the assessment of overall burden of disease. Psoriasis has been known for its major impact on patients' QOL and various generic, dermatology-specific and psoriasis-specific self-administered psychometric instruments have been used over the years to assess the QOL of psoriasis patients. However, the Dermatology Life Quality Index (DLQI) is the most widely used QOL measure among these measures in psoriasis-related clinical trials. A number of topical and systemic treatments have been used in the management of psoriasis and lately biologics have emerged as a new and promising treatment modality for difficult-to-treat psoriasis. The evidence on the efficacy of these agents has been growing dramatically with QOL being used as one of the primary outcome measures in many clinical trials. The aim of this paper is to give an overview of the use of the DLQI as an outcome measure for assessing the QOL impact of biologics on psoriasis patients. Furthermore, the efficacy of five commonly used biologics has been compared in terms of their ability to improve the QOL assessed by the DLQI. This review has revealed that there is a variation in the efficacy of various biologics in terms of QOL improvement with the mean reduction in the DLQI scores being highest for ustekinumab 90 mg (mean DLQI score reduction=9.5), followed by infliximab (8.5), etanercept 50 mg, twice a week (7.7), adalimumab (6.3), and alefacept (4.0).
Biological Products ; therapeutic use ; Clinical Trials as Topic ; Dermatologic Agents ; therapeutic use ; Dermatology ; Humans ; Psoriasis ; drug therapy ; Quality of Life