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)x10(9)/L and 2.7 to 124.0 (median 54.5)x10(9)/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 microg/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.