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KMID : 0366220130480010031
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Korean Journal of Hematology
2013 Volume.48 No. 1 p.31 ~ p.34
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Current routine practice and clinico-pathological characteristics associated with acute promyelocytic leukemia in Korea
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Ahn Sun-Hyun
Park Joon-Seong
Jeong Seong-Hyun
Lee Hyun-Woo
Park Jun-Eun
Kim Mi-Hyang
Kim Yang-Soo
Lee Ho-Sup
Park Tae-Sung
You Eun-Kyoung
Rheem In-Soo
Park Joo-Won
Huh Ji-Young
Kang Myung-Seo
Cho Sung-Ran
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Abstract
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Background: Acute promyelocytic leukemia (APL) can be life threatening, necessitating emergency therapy with prompt diagnosis by morphologic findings, immunophenotyping, cytogenetic analysis, or molecular studies. This study aimed to assess the current routine practices in APL and the clinico-pathologic features of APL. Methods: We reviewed the medical records of 48 Korean patients (25 men, 23 women; median age, 51 (20?80) years) diagnosed with APL in 5 university hospitals between March 2007 and February 2012. Results: The WBC count at diagnosis and platelet count varied from 0.4 to 81.0 (median 2.0)×109/L and 2.7 to 124.0 (median 54.5)×109/L, respectively. The median values for prothrombin time and activated partial thromboplastin time were 14.7 (11.3?44.1) s and 29 (24?62) s, respectively. All but 2 patients (96%) showed a fibrin/fibrinogen degradation product value of ＞20 mg/mL. The D-dimer median value was 5,000 (686?55,630) ng/mL. The t(15;17)(q22;q12 and PML-RARA fusion was found in all patients by chromosome analysis and/or multiplex reverse transcriptase-polymerase chain reaction (RT-PCR), with turnaround times of 8 (2?19) d and 7 (2?13) d, respectively. All patients received induction chemotherapy: all-trans retinoic acid (ATRA) alone (N=11, 26%), ATRA+idarubicin (N=25, 58%), ATRA+cytarabine (N=3, 7%), ATRA+idarubicin+cytarabine (N=4, 9%). Conclusion: Since APL is a medical emergency and an accurate diagnosis is a prerequisite for prompt treatment, laboratory support to implement faster diagnostic tools to confirm the presence of PML-RARA is required.
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KEYWORD
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Acute promyelocytic leukemia, PML-RARA, Immunophenotyping, Cytogenetic analysis, All-trans retinoic acid
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