Clinicopathologic features and outcome of 647 patients with newly diagnosed APL treated with 3 different induction regimens
| Parameters . | ATRA/chemotherapy . | ATRA/IV-ATO . | Oral-AAA . | P value∗ . |
|---|---|---|---|---|
| Total number | 436 | 61 | 150 | |
| Sex | ||||
| Male | 228 (52%) | 36 (59%) | 60 (40%) | .01 |
| Female | 208 (48%) | 25 (41%) | 90 (60%) | |
| Age, y | ||||
| Median (IQR) | 44 (33.7-54.7) | 45 (33.7-62.9) | 52 (40.5-63.7) | <.001 |
| ≤50 | 287 (66%) | 37 (61%) | 72 (48%) | .001 |
| >50 | 149 (34%) | 24 (39%) | 78 (52%) | |
| Presentation leukocyte†, × 109/L | ||||
| Median (IQR) | 3.8 (1.5-13.4) | 2.6 (1.31-13.4) | 3.2 (1.3-12.7) | .43 |
| ≤10 | 285 (65%) | 43 (71%) | 104 (69%) | .88 |
| >10 | 135 (31%) | 18 (30%) | 46 (31%) | |
| Presentation platelet‡, × 109/L | ||||
| Median (IQR) | 28 (15-49) | 42 (20-65) | 24 (14-39) | .003 |
| ≤40 | 273 (66%) | 29 (48%) | 114 (76%) | .001 |
| >40 | 143 (34%) | 31 (52%) | 36 (24%) | |
| Sanz risk score§ | ||||
| Low | 93 (22%) | 21 (34%) | 28 (19%) | .13 |
| Intermediate | 191 (46%) | 22 (36%) | 76 (51%) | |
| High | 135 (32%) | 18 (30%) | 46 (31%) | |
| APL morphology | ||||
| Classical | 408 (94%) | 61 (100%) | 135 (90%) | .03 |
| Microgranular variant | 28 (6%) | 0 | 15 (10%) | |
| Therapy-related APL | 15 (3%) | 2 (3%) | 5 (3%) | .99 |
| Additional karyotypic abnormalities | 96 (22%) | 14 (23%) | 42 (28%) | .41 |
| PML::RARA isoform|| | ||||
| bcr1 | 80 (66%) | 4 (40%) | 62 (63%) | .49 |
| bcr2 | 4 (3%) | 1 (10%) | 3 (3%) | |
| bcr3 | 37 (31%) | 5 (50%) | 34 (34%) | |
| CNS involvement | 22 (5%) | 3 (5%) | 11 (7%) | .56 |
| Peak leukocyte count¶, × 109/L | ||||
| Median (IQR) | 13.7 (4.6-31.9) | 19.6 (7.4-40.6) | 16.1 (6.7-30.1) | .13 |
| ≤10 | 162 (41%) | 21 (34%) | 49 (33%) | .17 |
| >10 | 230 (59%) | 40 (66%) | 99 (67%) | |
| APL-DS | 129 (30%) | 21 (34%) | 79 (53%) | <.001 |
| Early deaths | 36 (8%) | 1 (2%) | 6 (4%) | .05 |
| Intracranial hemorrhage | 13 (36%) | 0 | 4 (67%) | |
| APL-DS | 15 (42%) | 0 | 2 (33%) | |
| Infection | 8 (22%) | 1 (100%) | 0 | |
| First CR | 399 (92%) | 59 (97%) | 144 (96%) | .05 |
| Median follow-up (IQR), mo | 102 (42-160) | 37 (21.5-66) | 46.5 (21-78) | <.001 |
| Relapse | 101 (25%) | 3 (5%) | 2 (1%) | <.001 |
| Second cancers | 28 (6%) | 3 (5%) | 2 (1%) | .05 |
| Cause of deaths | ||||
| All causes | 92 (21%) | 7 (12%) | 12 (8%) | .001 |
| Early/induction deaths | 36 (39%) | 1 (14%) | 6 (50%) | |
| Refractory APL | 23 (25%) | 2 (29%) | 1 (8%) | |
| Treatment-related complications | 3 (3%) | 0 | 1 (8%) | |
| Infection | 12 (13%) | 1 (14%) | 4 (33%) | |
| Cardiovascular events | 2 (2%) | 0 | 0 | |
| Second primary cancers | 11 (12%) | 3 (43%) | 0 | |
| Unknown | 5 (5%) | 0 | 0 |
| Parameters . | ATRA/chemotherapy . | ATRA/IV-ATO . | Oral-AAA . | P value∗ . |
|---|---|---|---|---|
| Total number | 436 | 61 | 150 | |
| Sex | ||||
| Male | 228 (52%) | 36 (59%) | 60 (40%) | .01 |
| Female | 208 (48%) | 25 (41%) | 90 (60%) | |
| Age, y | ||||
| Median (IQR) | 44 (33.7-54.7) | 45 (33.7-62.9) | 52 (40.5-63.7) | <.001 |
| ≤50 | 287 (66%) | 37 (61%) | 72 (48%) | .001 |
| >50 | 149 (34%) | 24 (39%) | 78 (52%) | |
| Presentation leukocyte†, × 109/L | ||||
| Median (IQR) | 3.8 (1.5-13.4) | 2.6 (1.31-13.4) | 3.2 (1.3-12.7) | .43 |
| ≤10 | 285 (65%) | 43 (71%) | 104 (69%) | .88 |
| >10 | 135 (31%) | 18 (30%) | 46 (31%) | |
| Presentation platelet‡, × 109/L | ||||
| Median (IQR) | 28 (15-49) | 42 (20-65) | 24 (14-39) | .003 |
| ≤40 | 273 (66%) | 29 (48%) | 114 (76%) | .001 |
| >40 | 143 (34%) | 31 (52%) | 36 (24%) | |
| Sanz risk score§ | ||||
| Low | 93 (22%) | 21 (34%) | 28 (19%) | .13 |
| Intermediate | 191 (46%) | 22 (36%) | 76 (51%) | |
| High | 135 (32%) | 18 (30%) | 46 (31%) | |
| APL morphology | ||||
| Classical | 408 (94%) | 61 (100%) | 135 (90%) | .03 |
| Microgranular variant | 28 (6%) | 0 | 15 (10%) | |
| Therapy-related APL | 15 (3%) | 2 (3%) | 5 (3%) | .99 |
| Additional karyotypic abnormalities | 96 (22%) | 14 (23%) | 42 (28%) | .41 |
| PML::RARA isoform|| | ||||
| bcr1 | 80 (66%) | 4 (40%) | 62 (63%) | .49 |
| bcr2 | 4 (3%) | 1 (10%) | 3 (3%) | |
| bcr3 | 37 (31%) | 5 (50%) | 34 (34%) | |
| CNS involvement | 22 (5%) | 3 (5%) | 11 (7%) | .56 |
| Peak leukocyte count¶, × 109/L | ||||
| Median (IQR) | 13.7 (4.6-31.9) | 19.6 (7.4-40.6) | 16.1 (6.7-30.1) | .13 |
| ≤10 | 162 (41%) | 21 (34%) | 49 (33%) | .17 |
| >10 | 230 (59%) | 40 (66%) | 99 (67%) | |
| APL-DS | 129 (30%) | 21 (34%) | 79 (53%) | <.001 |
| Early deaths | 36 (8%) | 1 (2%) | 6 (4%) | .05 |
| Intracranial hemorrhage | 13 (36%) | 0 | 4 (67%) | |
| APL-DS | 15 (42%) | 0 | 2 (33%) | |
| Infection | 8 (22%) | 1 (100%) | 0 | |
| First CR | 399 (92%) | 59 (97%) | 144 (96%) | .05 |
| Median follow-up (IQR), mo | 102 (42-160) | 37 (21.5-66) | 46.5 (21-78) | <.001 |
| Relapse | 101 (25%) | 3 (5%) | 2 (1%) | <.001 |
| Second cancers | 28 (6%) | 3 (5%) | 2 (1%) | .05 |
| Cause of deaths | ||||
| All causes | 92 (21%) | 7 (12%) | 12 (8%) | .001 |
| Early/induction deaths | 36 (39%) | 1 (14%) | 6 (50%) | |
| Refractory APL | 23 (25%) | 2 (29%) | 1 (8%) | |
| Treatment-related complications | 3 (3%) | 0 | 1 (8%) | |
| Infection | 12 (13%) | 1 (14%) | 4 (33%) | |
| Cardiovascular events | 2 (2%) | 0 | 0 | |
| Second primary cancers | 11 (12%) | 3 (43%) | 0 | |
| Unknown | 5 (5%) | 0 | 0 |
χ2 for categorical variables, and independent sample Kruskal-Wallis test for continuous variables.
Missing data in 16 patients (2.5%).
Missing data in 21 patients (3.2%).
Missing data in 17 patients (2.6%).
PML::RARA transcript subtype was not determined in 417 patients (64.5%).
Missing data in 46 patients (7.1%).