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Continuing high early death rate in acute promyelocytic leukemia: a population-based report from the Swedish Adult Acute Leukemia Registry
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2011 (English)In: Leukemia, ISSN 0887-6924, E-ISSN 1476-5551, Vol. 25, no 7, p. 1128-1134Article in journal (Refereed) Published
Abstract [en]

Our knowledge about acute promyelocytic leukemia (APL) patients is mainly based on data from clinical trials, whereas population-based information is scarce. We studied APL patients diagnosed between 1997 and 2006 in the population-based Swedish Adult Acute Leukemia Registry. Of a total of 3897 acute leukemia cases, 3205 (82%) had non-APL acute myeloid leukemia (AML) and 105 (2.7%) had APL. The incidence of APL was 0.145 per 100 000 inhabitants per year. The median age at the time of diagnosis was 54 years; 62% were female and 38% male. Among younger APL patients, female sex predominated (89% of patients <40 years). Of the 105 APL patients, 30 (29%) died within 30 days (that is, early death (ED)) (median 4 days) and 28 (26%) within 14 days from diagnosis. In all, 41% of the EDs were due to hemorrhage; 35% of ED patients never received all-trans-retinoic acid treatment. ED rates increased with age but more clearly with poor performance status. ED was also associated with high white blood cells, lactate dehydrogenase, creatinine, C-reactive protein and low platelet count. Of non-ED patients, 97% achieved complete remission of which 16% subsequently relapsed. In total, 62% are still alive at 6.4 years median follow-up. We conclude that ED rates remain very high in an unselected APL population.

Place, publisher, year, edition, pages
Nature Publishing Group, 2011. Vol. 25, no 7, p. 1128-1134
Keywords [en]
acute promyelocytic leukemia; incidence; early mortality; hemorrhagic death; population based
National Category
Cancer and Oncology Hematology
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URN: urn:nbn:se:oru:diva-22581DOI: 10.1038/leu.2011.78ISI: 000292682600008PubMedID: 21502956Scopus ID: 2-s2.0-85027932070OAI: oai:DiVA.org:oru-22581DiVA, id: diva2:516606
Available from: 2012-04-18 Created: 2012-04-18 Last updated: 2018-02-19Bibliographically approved

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Tidefelt, Ulf

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School of Health and Medical Sciences, Örebro University, Sweden
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