Here presented a clinical study of 13 cases with acute promyelocytic leukemia, admitted to the Department of Internal Medicine, Yonsei University, College of Medicine during the period from May 1969 to June 1975.
Among the acute leukemias of the myeloid group, acute promyelocytic leukemia is characterized by the severe hemorrhage, the frequent ocurrence of hypofibrinogenemia, a rapidly fatal course, and an unusual cellular hyperplasia. Myelograms show an increased proportion (average 80%) of characteristic cells of large diameter, with numerous azurophilic granules. The infiltration of other organs is inconstant.
This study was attempted to review the sex and age distribution, incidence among acute leukemias, initial, symptoms, hematologic findings, chemotherapeutic responses, and clinical courses in patients with acute promyelocytic leukemia.
The results obtained are as follows:
1. The incidence of acute promyelocytic leukemia was 6. 5% of all cases of acute leukemia(199 cases).
2. The male to female ratio was 2.3 : 1. The majority of the patients were in the 2nd decade (5/13).
3. The bleeding tendency was a major symptom in 10 (76.9%), fever and chilling in 6 (46.2%), dizziness and pallor in 4(30.8%), and easy fatigability in 1 out of 13 cases.
4. Hepatomegaly and splenomegaly were present in 3 respectively and there was no case demonstrating lymphadenopathy.
5. Peripheral blood study revealed severe anemia and thrombocytopenia with 6.8 gm % of hemoglobin and 21,000/mm3 platelet count on the average. The blast-was 5.7% and promyelocyte 29.8%.
6. On the.bone marrow study, M/E ratio was 45:1, blast 3. 9%, promyelocyte 72.8% on the average.
7. Blood fibrinogen levels checked in 4 cases were normal. Bleeding and coagulation times were also normal in 3 except 1 case in which the bleeding time was prolonged to over 15 minutes.
8. Patients were treated with prednisolone, 6 mercaptopurine, vincristine, and cyclophosphamide without benefit. Four died of C.V.A. out of 6 cases whose deaths were confirmed. The mean duration from the onset of the initial symptoms to death was 52 days, and from admission to death 7 days.
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