Factors Affecting Early Death and Survival of Patients With Acute Promyelocytic Leukemia Treated With ATRA-Based Therapy Regimens

Abstract Purpose To perform a retrospective analysis of the prognostic relevance of clinicopathologic parameters in a well-documented cohort of patients treated with all- trans -retinoic acid (ATRA)-based induction regimens in order to discover which indicators can predict a high risk of early death (ED) and patient survival. Patients and Methods We analyzed data of 288 newly diagnosed adult acute promyelocytic leukemia patients in Hangzhou, China. The median follow-up time was 32 months (range, 6-78 months). Results The 3-year disease-free and overall survival rates were 90.83% and 91.69%, respectively. In the multivariable analysis, older age (≥ 60 years) was the only independent risk factor for ED (hazard ratio [HR] = 15.057; P  = .004). High white blood cell count was not a risk factor for ED ( P  = .055), but it was for relapse (HR = 2.7; P  = .009). FLT3 mutation (HR = 3.9; 95% confidence interval, 1.4 to 10; P  = .007) and older age (≥ 60 years) (HR = 5.3; 95% confidence interval, 2.4 to 11; P P  = .049) was a prognostic factor for relapse. The ED rate was 5.9% (17/288 patients). Conclusion The perceived impact of the identification of these high-risk factors should be described in order to decide whether any modifications to treatment strategy should be entertained.