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

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Author

  • 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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Summary, in English

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

Publishing year

2011

Language

English

Pages

1128-1134

Publication/Series

Leukemia

Volume

25

Issue

7

Document type

Journal article

Publisher

Nature Publishing Group

Topic

  • Cancer and Oncology

Keywords

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

Status

Published

ISBN/ISSN/Other

  • ISSN: 1476-5551