Characteristics and Outcomes of Patients with Acute Promyelocytic Leukemia: A Single-center Experience

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Seçilmiş S., Candır B. A., Bozan E., Yaman S., Ulu B. U., YİĞENOĞLU T. N., ...Daha Fazla

Acta Haematologica Oncologica Turcica, cilt.58, sa.2, ss.143-149, 2025 (Scopus, TRDizin)

Özet

Aim: Acute promyelocytic leukemia (APL) is defined by the t(15;17) chromosomal translocation, resulting in the promyelocytic leukemia-retinoic acid receptor alpha fusion gene. The introduction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) has led to survival rates surpassing 90%. This study evaluated the clinical features and outcomes of APL patients managed at our center. Methods: A retrospective review was conducted on 27 APL patients treated between January 2010 and February 2022. Results: The median patient age was 41 years (range: 18-82). Risk classification identified 14 low-risk (51.9%), 10 intermediate-risk (37.0%), and three high-risk (11.1%) patients. Induction treatment involved ATRA plus chemotherapy (CT) in 21 cases and ATRA plus ATO in six cases. All patients achieved complete remission. At a median follow-up of 49 months (6-140), neither median overall survival nor progression-free survival had been reached. Relapse occurred in five patients (18.5%); four underwent successful salvage therapy followed by autologous transplantation. One patient with CNS relapse achieved remission after intrathecal therapy but later died due to cerebral hemorrhage during transplant preparation. Major non-hematologic toxicities included infections (66.6%) and differentiation syndrome (48.1%). Neutropenic fever and thrombocytopenia were the most frequent grade 3-4 hematologic events. No deaths were attributed to treatment-related adverse events. Conclusion: Newly diagnosed APL remains a curable malignancy with high response rates when treated with ATRA-based regimens involving CT or ATO.