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Acute promyelocytic leukemia: treatment results during a decade at Memorial
Hospital
I Cunningham, TS Gee, LM Reich, SJ Kempin, AN Naval and BD Clarkson
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York
10021.
Fifty-seven adult patients with acute promyelocytic leukemia (APL) were
treated between 1974 and 1984 with daunorubicin (DNR) or 4-(9-
acridinylamino)methanesulfan-m-anisidide (AMSA) in combination with
arabinosylcytosine (Ara-C) and 6-thioguanine (TG); they also received
prophylactic heparin. Forty-one patients (72%) achieved complete remission
(CR), including 11 of 12 patients who received the AMSA- containing
regimen. The incidence of early fatal hemorrhage was 14%, lower than that
of earlier studies or other published reports. Elevated WBC and serum
lactate dehydrogenase levels at diagnosis were associated with an increased
incidence of life-threatening hemorrhage and shorter remission duration.
Advanced age was an unfavorable prognostic factor for male patients. Both
DNR and AMSA in combination protocols are effective treatments for APL. The
incidence of CR is similar to that achieved in other types of acute
nonlymphoblastic leukemia (ANLL) with the same protocols, but the median
duration of remission is significantly longer in APL (24 v 9 months) and
the percentage of remissions longer than 60 months is also higher in APL
(35% v 5%).
Volume 73,
Issue 5,
pp. 1116-1122,
04/01/1989
Copyright © 1989 by The American Society of Hematology
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