Clinical study of elderly patients with acute promyelocytic leukemia / 白血病·淋巴瘤

ABSTRACT

Objective To investigate the clinical features, therapy and prognosis of elderly patients with newly diagnosed acute promyelocytic leukemia (APL). Methods The clinical features of 21 elderly patients and 89 patients aged ＜60 with newly diagnosed APL were retrospectively analyzed. Additionally,elderly patients were divided into different groups according to the count of white blood cell (WBC). Results There were no significant differences between elderly patients and patients aged ＜60 in the aspect of sex (male/female: 11/10 vs 47/42), WBC count (high initial WBC: 23.8 % vs 16.9 %), the percentage of bone marrow blasts plus promyelocytes (0.83±0.11 vs 0.83±0.12), complete remission (CR) rate (71.4 % vs 84.3 %),the time of CR occurrence (35.7±10.1 vs 39.1±13.5), the occurrence of retinoic acid syndrome(RAS) (14.3 % vs 22.5 %), disseminated intravascular coagulation (DIC) (52.4 % vs 34.8 %) as well as 2 years overall survival rate (72.7 % vs 80.0 %) (P ＞0.05). Of the 21 elderly patients who received inductive treatment, 5 with high initial WBC and 16 without high initial WBC. The incidences of DIC, early death in high initial WBC group were 80 %, 60 % respectively, which were higher than the group without high initial WBC (43.8 %,18.8 % respectively), whereas CR rate for the group with high initial WBC (40.0 %) was lower than that for the group without high initial WBC (81.3 %). Conclusion Elderly patients with APL could have fine prognosis as well as patients aged ＜60. The results of inductive treatment of elderly patients in high initial WBC group were poor as compared with the group without high initial WBC.