Inclusion of hemoglobin level in prognostic score provides better prognostic stratification in patients with acute promyelocytic leukemia (APL)

Silvia Park, Su Jin Lee, Kihyun Kim, Jun Ho Jang, Dong Hwan Kim, Kyu Hyung Lee, Je Hwan Lee, Jung Hee Lee, Dae Young Kim, Dae Young Jang, Hawk Kim, Jae Hoo Park, Hun Mo Ryoo, Sung Hwa Bae, Min Kyung Kim, Myung Soo Hyun, Young Don Joo, Won Sik Lee, Sang Min Lee, Chul Won Jung

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

The clinical outcomes of acute promyelocytic leukemia (APL) have improved greatly, but treatment failure still occurs. Identification of patients with poor prognosis is fundamental, and we propose a new clinical prognostic system (CBC-score) consisting of WBC, platelet count, and hemoglobin level. Between 1995 and 2009, 156 patients with APL from seven institutes in Korea were retrospectively reviewed. In the new CBC-score system, each of the following (WBC ≤ 10 × 109/L, platelet \40 9 109/L, hemoglobin< 8.0 g/dL) was considered as a risk factor; the sum of each was designated as the CBCscore. With a median follow-up of 8.4 years, the complete remission (CR) rate was 81.4 % (127/156), while 24 (15.4 %) were considered as treatment failures due to early death (ED). The 5-year overall survival (OS), leukemia-free survival, and cumulative incidence of relapse were 73.8, 82.8, and 13.5 %, respectively. Compared to the individual CBC parameters, combined prognostic systems such as PETHEMA or CBC-score provided better prognostic stratification. Compared to PETHEMA stratification, the proposed prognostic CBC-score system showed better stratification of APL patients in terms of CR rates (p = 0.004), OS (p = 0.004), and ED (p = 0.008). This retrospective study suggests that the proposed CBC-score may provide better prognostic stratification of APL patients.

Original languageEnglish
Pages (from-to)388-396
Number of pages9
JournalInternational Journal of Hematology
Volume97
Issue number3
DOIs
StatePublished - Mar 2013

Keywords

  • APL
  • Hemoglobin
  • Prognostic system

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