Acute promyelocytic leukemia(APL) is characterized by the proliferation of
hypergranular atypical promyelocytes and marked bleeding tendency. The bleeding is
associated with disseminated intravascular coagulation, which triggered by procoagulants
released from promyelocytic granules. In order to predict the clinical course and
prognosis of disease, many efforts have been tried through the clinical, laboratory and
morphological aspects. The authors analyzed twenty two cases of APL from January,
1979 to September, 1988 at Hanyang University Hospital to estimate correlation of
hematological and clinical features with prognosis. The results were following :
1. Incidence of APL was 9.8% of AML and 6.9% of acute leukemia.
2. The age range was 5 to 75 years with mean 31 years. The male to female ratio
was 1.8 : 1.
3. Many patients presented with fever and hemorrhagic symptoms, but there was no
correlation of fever and bleeding at presentation to prognosis.
4. High platelets group had higher complete remission rate than low platelets group
(p<0.002) and there was no correlation of peripheral blood findings and chemical studies
to prognosis.
5. The group of patients having cells with ragged cytoplasm, inconspicuous nucleoli,
irregular cell size and many granules in intercellular space had more disseminated
intravascular coagulation.
6. The group of patients having cells with many Auer rods, smooth cytoplasmic
margin, Prominent nucleoli, regular cell size and few granules in intercellular space had
hihger CR rate.
7. The complete remission rate was 18% and mean remission duration was 8.7
months, and central nervous system bleeding was the most common cause of
death(38%).
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