Characteristics features and factors influencing early death in acute promyelocytic leukemia; Experience from United Arab Emirates (UAE) Journal Article
| Authors: | Hassan, I. B.; Zaabi, M. R. A.; Alam, A.; Hashim, M. J.; Tallman, M. S.; Kristensen, J. |
| Article Title: | Characteristics features and factors influencing early death in acute promyelocytic leukemia; Experience from United Arab Emirates (UAE) |
| Abstract: | Although acute promyelocytic leukemia (APL) is a curable hematologic malignancy, early death (ED) remains a significant cause of treatment failure especially in developing countries. In a retrospective data analysis of 67 adult APL patients diagnosed in United Arab Emirates we report an ED rate of 11.9% which is comparable to that reported from more developed countries. We identified the following parameters at presentation as significant predictor of increased ED: Age >40 years (P = 0.015), fever (P = 0.030), WBC count >20 × 109/L (P = 0.010), the breakpoints other than bcr1 (P = 0.043) and fibrinogen level <1.5 g/L (P = 0.025). Delay in ATRA administration beyond 24 h from admission and fibrinogen <150 mg/dL were also significant predictors of ED, but only among high-risk patients (P = 0.035 and P = 0.033, respectively). WBC count >10 × 109/L and expression of HLA-DR (P = 0.018) or CD2 (P = 0.017) were significant predictors for differentiation syndrome (DS) which was found to be a predictor of ED (P = 0.002). Reducing the APL related ED rate in centers with limited resources is feasible provided early initiation of ATRA administration and early correction of coagulopathy in high-risk patients in addition to prompt treatment of DS. To our knowledge this is the first report from the Arabian Gulf describing ED in APL. © 2017, The Japanese Society of Hematology. |
| Keywords: | adolescent; adult; treatment outcome; middle aged; young adult; major clinical study; clinical feature; mortality; doxorubicin; cancer combination chemotherapy; cancer risk; cancer patient; cytarabine; methotrexate; antineoplastic agent; phenotype; multiple cycle treatment; breast cancer; antineoplastic combined chemotherapy protocols; hemoglobin; retrospective study; cancer mortality; high risk patient; hodgkin disease; fever; arsenic trioxide; leukemia, promyelocytic, acute; mitoxantrone; therapy delay; daunorubicin; promyelocytic leukemia; hospital admission; leukocyte count; idarubicin; chromosome analysis; retinoic acid; cytogenetic analysis; induction chemotherapy; fibrinogen; fibrinogen blood level; partial thromboplastin time; mercaptopurine; blood examination; blood clotting; blood coagulation; acute promyelocytic leukemia; cryoprecipitate; hematologic tests; fresh frozen plasma; international normalized ratio; mortality rate; anthracycline antibiotic agent; maintenance chemotherapy; consolidation chemotherapy; time to treatment; monosomy 7; early death; time-to-treatment; humans; prognosis; human; male; female; article; ring chromosome; united arab emirates |
| Journal Title: | International Journal of Hematology |
| Volume: | 106 |
| Issue: | 1 |
| ISSN: | 0925-5710 |
| Publisher: | Springer Japan KK |
| Date Published: | 2017-07-01 |
| Start Page: | 90 |
| End Page: | 98 |
| Language: | English |
| DOI: | 10.1007/s12185-017-2211-7 |
| PUBMED: | 28293819 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 August 2017 -- Source: Scopus |
