Clinico-biological characteristics and therapeutic results of acute promyelocytic leukemia. Report of 57 clinical cases at Batna’s Anti-Cancer Center

Abstract

Introduction and objective. Acute myeloid leukemias are clonal heterogeneous hematologic malignancies due to the transformation of a hematopoietic stem cell or a committed progenitor to the myeloid lineage. AML type 3 is a particular form of acute myeloid leukemia clinically, cytologically and molecularly. One of the main objectives to achieve in the current therapeutic strategy; the introduction of a targeted treatment all transretinoic acid (ATRA) and more recently arsenic trioxide (ATO), coupled with the improvement of the symptomatic treatment has upset the prognosis of this form of acute leukemia which has become currently the most consistently curable. Material and methods. Over a period of 5 years, from January 2016 to December 2020, 57 patients (pts) or 14% with AML 3 were diagnosed among 220 pts with acute myeloid leukemia. All patients received a chemotherapy protocol including transretinoic acid. Results. According to their place of residence, the city of Batna had the highest frequency of 25%. Then the city of El Oued (12%) and Biskra (12%). The overall median age was 37 years (36.6 years for men and 37 for women). The blood count showed a variable white blood cell (WBC) count, with leukopenia found in 27.3% of cases, normal WBC count in 18.2% of cases, and high WBC count in 54.5% of cases. Clinical presentation of AML at diagnosis was most often characterized by severe anemia, thrombocytopenia and leukocytosis up to 140.109g/L. It is noteworthy that anemia was present in all patients (hemoglobin range 4.7 10.8 g/dL). Of these 57 pts, the median age was 37 years (5 to 85). In terms of diagnostic means, cytochemistry was used in more than 47% of the cases, flow cytometry was used in 79%. Conclusion. From the therapeutic impact point of view, this study highlights the young age of the patients which represents the most discriminating prognostic factor and thus allows to orient the therapeutic strategy towards chemotherapy protocols close to those used in pediatrics.