Premium
Acute promyelocytic leukemia in 57 previously untreated patients
Author(s) -
Cordonnier Catherine,
Vernant Jean Paul,
Brun Bernard,
Heilmann Michèle Gouault,
Kuentz Mathieu,
Bierling Philippe,
Farcet Jean Pierre,
Rodet Martine,
Duedari Nagib,
Imbert Michèle,
Jouault Hélène,
Mani Patrice,
Reyes Félix,
Dreyfus Bernard,
Rochant Henri
Publication year - 1985
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19850101)55:1<18::aid-cncr2820550104>3.0.co;2-b
Subject(s) - medicine , disseminated intravascular coagulation , acute promyelocytic leukemia , respiratory failure , gastroenterology , induction chemotherapy , surgery , daunorubicin , leukemia , mortality rate , chemotherapy , biochemistry , retinoic acid , chemistry , gene
Fifty‐seven patients in initial phase of acute promyelocytic leukemia (APL) were treated in the same department with heparin infusion, platelet transfusions, and two related induction regimens both including cytosine arabinoside and daunorubicin. Clinical and biological findings at presentation were studied. The complete remission (CR) rate was 53%. Twenty‐seven patients (47%) died during the initial course of the disease, either before day 5 (early death [ED], n = 7) or after day 5 (death in aplasia [DA], n = 20). Most ED was due to intracerebral hemorrhage (6/7), especially when large hemorrhages had been seen on fundus oculi examination. Most DA was due to multivisceral failure (9/20). No correlation was found between initial disseminated intravascular coagulation (DIC) and death. However, the worsening of coagulation parameters during induction therapy, with or without initial DIC, significantly increased the occurrence of renal and respiratory failure which were particularly frequent during the first month. The median duration of survival was short (3.5 months) and the median duration of CR (11 months) was similar to that of other acute myeloid leukemias treated with the same regimens. The possible causes of the high mortality observed during the initial courses of APL and the possible benefit of a more graduate induction chemotherapy are discussed.