Acute promyelocytic leukaemia: a retrospective analysis of patients treated at St. Bartholomew's Hospital 1969-1995.
Seventy-two patients with acute promyelocytic leukemia (APML) were treated at St.Bartholomew's Hospital (SBH) over a 25-year period. Improvements in supportive care and the use of more intensive chemotherapy have led to an increase in the complete remission rate from 14 to 58%. Similarly, the median survival has increased from 3 weeks to 2 years; the median duration of remission, which was 7 months in 1974, has not yet been reached. There was also a significant difference in survival from first recurrence, compared with that of patients with other subtypes of acute myeloid leukemia. RT-PCR analysis on bone marrow samples from 14 patients confirmed the presence of the PML/RARA fusion; 13 of the 14 patients achieved 'molecular remission' after therapy. The one patient who remained persistently positive experienced recurrence within 4 months. In seven of the eight patients in whom the disease recurred, the translocation was identified by RT-PCR at the time of relapse, whilst in one patient it was noted 4 months prior to morphological recurrence. These results illustrate the improvement in prognosis that occurred over a 25-year period in patients with APML treated at a single centre.
Slater
S
S
ICRF Department of Medical Oncology, St. Bartholomew's Hospital, London, Great Britain.
Carter
M
M
Howe
K
K
Amess
J
J
Rohatiner
A Z
AZ
Lister
T A
TA
D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002869:Chromosome Aberrations; D003561:Cytarabine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000235:genetics / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012334:RNA, Neoplasm / Q000032:analysis; D012008:Recurrence; D012074:Remission Induction; D012176:Retinoids / Q000627:therapeutic use; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate; D013997:Time Factors; D006113:United Kingdom
D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D012334:RNA, Neoplasm; D012176:Retinoids; D003561:Cytarabine