Continuing high early death rate in acute promyelocytic leukemia: a population-based report from the Swedish Adult Acute Leukemia Registry

S. Lehmann, A. Ravn, L. Carlsson, P. Antunovic, S. Deneberg, L. Mollgard, A. Rangert Derolf, D. Stockelberg, U. Tidefelt, A. Wahlin, L. Wennstrom, M. Hoglund, Gunnar Juliusson

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219 Citations (SciVal)

Abstract

Our knowledge about acute promyelocytic leukemia (APL) patients is mainly based on data from clinical trials, whereas population-based information is scarce. We studied APL patients diagnosed between 1997 and 2006 in the population-based Swedish Adult Acute Leukemia Registry. Of a total of 3897 acute leukemia cases, 3205 (82%) had non-APL acute myeloid leukemia (AML) and 105 (2.7%) had APL. The incidence of APL was 0.145 per 100 000 inhabitants per year. The median age at the time of diagnosis was 54 years; 62% were female and 38% male. Among younger APL patients, female sex predominated (89% of patients < 40 years). Of the 105 APL patients, 30 (29%) died within 30 days (that is, early death (ED)) (median 4 days) and 28 (26%) within 14 days from diagnosis. In all, 41% of the EDs were due to hemorrhage; 35% of ED patients never received all-trans-retinoic acid treatment. ED rates increased with age but more clearly with poor performance status. ED was also associated with high white blood cells, lactate dehydro-genase, creatinine, C-reactive protein and low platelet count. Of non-ED patients, 97% achieved complete remission of which 16% subsequently relapsed. In total, 62% are still alive at 6.4 years median follow-up. We conclude that ED rates remain very high in an unselected APL population. Leukemia (2011) 25, 1128-1134; doi:10.1038/leu.2011.78; published online 19 April 2011
Original languageEnglish
Pages (from-to)1128-1134
JournalLeukemia
Volume25
Issue number7
DOIs
Publication statusPublished - 2011

Subject classification (UKÄ)

  • Cancer and Oncology

Keywords

  • acute promyelocytic leukemia
  • incidence
  • early mortality
  • hemorrhagic
  • death
  • population based

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