Early Mortality in Children and Adolescents with Acute Promyelocytic Leukemia: Experience of the Boldrini Children’s Center
| Autor: | Julia Y Cervellini, Cristiane C Omae, Larissa R Prandi, Patrícia Y. Jotta, Silvia Regina Brandalise, Eduardo I. Matsuda, Ricardo Mendes Pereira, Amilcar Cardoso de Azevedo |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Acute promyelocytic leukemia medicine.medical_specialty Adolescent Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Leukemia Promyelocytic Acute White blood cell Internal medicine medicine Humans Child Retrospective Studies Prothrombin time Creatinine medicine.diagnostic_test business.industry Hematology Odds ratio medicine.disease Leukemia medicine.anatomical_structure Oncology chemistry 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Female business Body mass index 030215 immunology Partial thromboplastin time |
| Zdroj: | Journal of Pediatric Hematology/Oncology. 42:e641-e646 |
| ISSN: | 1077-4114 |
| DOI: | 10.1097/mph.0000000000001601 |
| Popis: | Introduction Acute promyelocytic leukemia (APL) is currently considered a highly curable disease. However, an early death (ED) remains one of the main causes of APL treatment failure. Patients and methods In this retrospective study, we aimed to analyze the clinical characteristics of 91 children and adolescents with APL, who were consecutively registered at the (name of institution removed) Children's Center from January 1, 1998 to December 31, 2017. Data were assessed for age, sex, ethnicity, body mass index percentile, initial white blood cell count, peripheral blood blast count, and platelet count, hemoglobin value, partial thromboplastin time, prothrombin time, fibrinogen level, serum creatinine level, APL morphology subtype (classic vs. hypogranular variant M3v), and FLT3 gene mutations. Results ED occurred in 12 of 91 (13.1%) patients and was mainly related to cerebral thromboembolism. Overall 66% of deaths occurred in the second week after diagnosis. ED was associated with white blood cell ≥10×10 cells/L (odds ratio of 8.44; 95% confidence interval [CI]=1.48-48.26; P=0.0016), initial promyelocytes ≥20×10/L (odds ratio of 9.29; 95% CI=2.45-35.8; P=0.001), morphologic subtype M3v (odds ratio of 3.63; 95% CI=1.04-12.64; P=0.043), and creatinine serum levels >0.7 mg/dL (odds ratio of 6.78; 95% CI=1.83-25.13; P=0.004). In multivariate analyses, ED was associated with initial peripheral promyelocytes ≥20×10 blasts/L and creatinine serum levels >0.7 mg/dL. Conclusions EDs were mainly caused by thrombohemorrhagic events and occurred within the second week after diagnosis. High peripheral promyelocytes and creatinine levels were predictors of ED in APL. |
| Databáze: | OpenAIRE |
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