The comparison of bone marrow kinetics between patients with acute myeloid leukemia and acute promyelocytic leukemia after induction chemotherapy.
Rafiye CiftcilerIbrahim C HaznedarogluOsman OzcebeSalih AksuNilgun SayınalpHakan GokerHaluk DemirogluYahya BuyukasıkPublished in: Immunopharmacology and immunotoxicology (2019)
Background and Aim: Recently, acute promyelocytic leukemia (APL) has shifted from the most hazardous to the best curable type of acute myeloid leukemia. Anthracyclines, all-trans retinoic acid (ATRA) and arsenic derivatives are the most important developments for the treatment of APL. ATRA promotes the terminal differentiation of malignant promyelocytes to mature neutrophils. We aimed to compare platelet and neutrophil recovery time after induction chemotherapy in patients with acute myeloid leukemia (AML) and APL.Materials and Methods: Two hundred and fifteen patients with AML and APL, who were diagnosed and treated in our tertiary care center between the years of 2001 and 2018 were evaluated.Results: One hundred and eighty one AML patients (84.2%) and 34 (15.8%) APL patients were included in this study. The time between neutrophil nadir after induction chemotherapy and neutrophil recovery was longer in APL patients than in AML patients [30.5 (4-52) vs. 20 (5-58), p < 0.001]. The time between platelet nadir after induction chemotherapy and platelet recovery was longer in APL patients than in AML patients [21.5 (4-42) vs. 17 (4-45), p = 0.02].Conclusion: Neutrophil and platelet recovery times were longer in APL patients than in AML patients in our present study. In 60 days, mortality rate was higher in APL patients than AML patients. Non-relapse mortality (NRM) rate was similar between two groups. There was a significant difference between two groups in terms of NRM causes. Platelet and neutrophil recovery time is very important because infection is the most important cause of NRM.
Keyphrases
- acute myeloid leukemia
- end stage renal disease
- newly diagnosed
- chronic kidney disease
- ejection fraction
- bone marrow
- prognostic factors
- risk assessment
- intensive care unit
- cardiovascular disease
- tertiary care
- allogeneic hematopoietic stem cell transplantation
- patient reported outcomes
- coronary artery disease
- mesenchymal stem cells
- respiratory failure
- patient reported
- mechanical ventilation
- clinical evaluation