An evaluation of clinical treatment in children with acute promyelocytic leukemia

Abstract

Objective To evaluate the clinical effect of acute promyelocytic leukemia (APL) protocol clinically at Nanjing Children's Hospital(NCH) 2009. Methods The clinical data of 21 patients including 15 boys and 6 girls with APL admitted from January 2009 to December 2014 were collected, and all patients were treated with NCH-2009-APL protocol.Initial diagnosis information, early treatment response and long term follow-up were analyzed. Results The median age of this group was 7.15 years.The initial leucocyte count exceed 50×109/L in 4 cases, 1 case was between 10×109/L and 50×109/L, and 16 cases were less than 10×109/L.All cases had t (15; 17) chromosome and/or PML/RARA fusion gene positive, and 19 children got complete remission(CR) after the first course of induction therapy.One got CR after the second course of induction therapy, but 1 died in the early phase of induction therapy.The CR rate was 95.24%.The median time to get CR was 34 days.Overall 5-year event free survival rate was 95% after standard chemotherapy with NCH-2009-APL protocol.All cases had various degrees of infection in the phase of induced remission, DAE and IA.Only 1 case died, 1 case had severe lung injury after infection, and the remaining patients got well recovery.The central nervous system leukemia, bone marrow relapse or extramedullary recurrence were not found in this study. Conclusion Patients with APL have high CR rate and better prognosis with the protocol of NCH-2009-APL. Key words: Acute promyelocytic leukemia; Chemotherapy; Child