Outcomes for Patients with Acute Promyelocytic Leukaemia in South Africa

Abstract The characteristics and outcomes of patients with acute promyelocytic leukaemia (APL) from sub-Saharan Africa have not been published. We report retrospectively on consecutively diagnosed APL patients treated in Cape Town, South Africa from 1998-2019. A total of 69 patients were treated, of whom 27 (39%) were classified as high risk APL. Early death rates at seven and 30 days were 7% and 13% respectively, including four patients who died before any treatment could be administered. Overall survival at 3 years was 76.5% (95% Confidence Interval [CI] 63.9 – 85.2) for the entire cohort, and 82.5% (95% CI 69.7 – 90.2) if patients who died within seven days of diagnosis were excluded. For 13 (18.8%) patients, there was a delay of five or more days from time of initial presentation at a peripheral hospital until arrival at the leukaemia centre and administration of ATRA; only one of these patients died within 30 days. In conclusion, despite the challenges faced in the public healthcare system of a developing country, outcomes of APL patients treated at our centre are similar to outcomes from developed countries.