CLINICAL CHARACTERISTICS AND PROGNOSIS OF ACUTE PROMYELOCYTIC LEUKEMIA PATIENTS IN FORTALEZA

Abstract

Acute Promyelocytic Leukemia (APL) is a specific and highly curable form of acute myeloid leukemia, characterized by the translocation t(15; 17) which results in the gene fusion PML::RARE. This fusion blocks the normal differentiation of promyelocytes, leading to the accumulation of immature cells. Typical treatment includes trans-retinoic acid (ATRA) and arsenic, which induce leukemic cell differentiation and result in high cure rates. This study aims to evaluate clinical and laboratory characteristics of patients with APL as well as investigate prognostic factors associated with survival. We analyzed data from 20 patients diagnosed with APL at the Hospital Geral de Fortaleza (HGF), which is the largest oncohematology outpatient clinic in the state of Ceará. Mann-Whitney tests were applied to evaluate the clinical data. Overall survival analysis was performed using the Kaplan-Meier method, stratifying patients by cytogenetic risk, according to the World Health Organization (WHO) and European LeukemiaNet (ELN) guidelines. Among the analyzed patients, the median age was 37.5 years (20-68 years). At the time of diagnosis, the patients had a mean hemoglobin count of 7.35 g/dL, White Blood Cell (WBC) Count above 10,000/mm3, and platelets below 50,000/mm3. The average percentage of blasts in the bone marrow was 86%. The mean overall survival of the patients studied was 8.18 months. The Kaplan-Meier analysis indicated that patients stratified as high-risk had a slightly higher probability of survival over time compared to low-risk patients. Overall survival over time was analyzed, showing a high overall survival probability for both groups. The data indicate that leukocyte and platelet counts are factors that demonstrated statistical significance among the groups studied, potentially influencing the prognosis of APL patients. Overall survival analysis suggests that risk stratification may be a useful tool in prognostic assessment and in defining treatment strategies. Additional studies with larger sample sizes are needed to confirm these findings and explore other potential prognostic factors. Detailed characterization of APL patients and identification of prognostic factors are essential for optimizing treatment and improving survival rates. Leukocyte and platelet count proved to be a significant parameter in this study, highlighting the importance of continuous monitoring and risk stratification in the APL management.