Abstract
BackgroundAcute promyelocytic leukemia (APL) is a special type of acute myeloid leukemia Thrombosis is at increased risk complication in patients with this disease. However, the risk factors of thrombosis related to Chinese APL patients are not fully understood.MethodsIn this study, clinical and laboratory data of 44 consecutively Chinese APL patients were collected and analyzed.ResultsOne arterial and 6 venous thrombosis occurred in 44 patients, including 22 males and 22 females, with a median age of 44 years (range from 18 to 74 years). The ratio of male and female gender, age, white blood cell count, hemoglobin, platelets, disease risk stratification, CD2, Khorana score, differentiation syndrome (DS) and gene mutation related to prognosis of APL, including DNMT3A, TET2, IDH1, IDH2, NRAS and ASXL1 in the two groups with and without thrombosis were not statistically significant. The detection rate of PAI-1 genotype 4G4G was 71.4% (5/7) in 7 patients with thrombosis, while the detection rate of PAI-1 genotype 4G4G in 37 patients without thrombosis was 8.1% (3/37). The differences between the two groups in WT-1 (P = 0.01), PAI-1 4G4G (P = 0.0009), bcr3 (P = 0.027), CD15 (P = 0.005), and FLT3-ITD mutation (P = 0.0008) were statistically significant. Using multivariate analysis, the risk factors of venous thrombosis in APL were CD15 (P = 0.043), PAI-1 4G4G (P = 0.009), WT-1 (P = 0.043) and FLT3/ITD (P = 0.013), respectively.ConclusionOur results suggested the PAI-1 gene 4G4G type, CD15, WT-1 and FLT3-ITD mutations excluding DNMT3A, TET2, IDH1/2, NRAS and ASXL1 are risk factors of thrombotic events in Chinese APL patients.
Highlights
Acute promyelocytic leukemia (APL) is a special type of acute myeloid leukemia with cytogenetic characteristics of t (15; 17) (q22; q21) formation the PML/RARa fusion gene [1,2,3]
The study population included 44 APL patients, 22 (50%) males and 22 (50%) females with a median age of 42 years. These population were all newly diagnosed APL patients admitted to our department from January 2013 to December 2019 and received treatment according to the PETHEMA APL99 protocol
No APL patients showed the symptoms of bleeding and thrombosis simultaneously
Summary
Acute promyelocytic leukemia (APL) is a special type of acute myeloid leukemia with cytogenetic characteristics of t (15; 17) (q22; q21) formation the PML/RARa fusion gene [1,2,3]. With regard to the risk factors of APL related thrombotic events, limited research results showed that they could be related to high leukocyte, CD2/CD15 positive, FLT3/ITD positive, PML/RARa fusion gene variant, retinoic acid syndrome, high platelet count and male [16,17,18]. The epidemiology and risk factors of APL related thrombotic events have not been fully discovered. Acute promyelocytic leukemia (APL) is a special type of acute myeloid leukemia Thrombosis is at increased risk complication in patients with this disease. The risk factors of thrombosis related to Chinese APL patients are not fully understood
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