PMID- 31613846
OWN - NLM
STAT- MEDLINE
DCOM- 20201230
LR  - 20210209
IS  - 1536-3678 (Electronic)
IS  - 1077-4114 (Linking)
VI  - 42
IP  - 7
DP  - 2020 Oct
TI  - Early Mortality in Children and Adolescents with Acute Promyelocytic Leukemia: 
      Experience of the Boldrini Children's Center.
PG  - e641-e646
LID - 10.1097/MPH.0000000000001601 [doi]
AB  - INTRODUCTION: Acute promyelocytic leukemia (APL) is currently considered a highly 
      curable disease. However, an early death (ED) remains one of the main causes of 
      APL treatment failure. PATIENTS AND METHODS: In this retrospective study, we 
      aimed to analyze the clinical characteristics of 91 children and adolescents with 
      APL, who were consecutively registered at the (name of institution removed) 
      Children's Center from January 1, 1998 to December 31, 2017. Data were assessed 
      for age, sex, ethnicity, body mass index percentile, initial white blood cell 
      count, peripheral blood blast count, and platelet count, hemoglobin value, 
      partial thromboplastin time, prothrombin time, fibrinogen level, serum creatinine 
      level, APL morphology subtype (classic vs. hypogranular variant M3v), and FLT3 
      gene mutations. RESULTS: ED occurred in 12 of 91 (13.1%) patients and was mainly 
      related to cerebral thromboembolism. Overall 66% of deaths occurred in the second 
      week after diagnosis. ED was associated with white blood cell >/=10x10 cells/L 
      (odds ratio of 8.44; 95% confidence interval [CI]=1.48-48.26; P=0.0016), initial 
      promyelocytes >/=20x10/L (odds ratio of 9.29; 95% CI=2.45-35.8; P=0.001), 
      morphologic subtype M3v (odds ratio of 3.63; 95% CI=1.04-12.64; P=0.043), and 
      creatinine serum levels >0.7 mg/dL (odds ratio of 6.78; 95% CI=1.83-25.13; 
      P=0.004). In multivariate analyses, ED was associated with initial peripheral 
      promyelocytes >/=20x10 blasts/L and creatinine serum levels >0.7 mg/dL. 
      CONCLUSIONS: EDs were mainly caused by thrombohemorrhagic events and occurred 
      within the second week after diagnosis. High peripheral promyelocytes and 
      creatinine levels were predictors of ED in APL.
FAU - de Azevedo, Amilcar C
AU  - de Azevedo AC
AD  - Boldrini Children's Center.
AD  - Graduate Program in Child and Adolescent Health.
FAU - Matsuda, Eduardo
AU  - Matsuda E
AD  - Boldrini Children's Center.
FAU - Cervellini, Julia Y
AU  - Cervellini JY
AD  - Boldrini Children's Center.
FAU - Prandi, Larissa R
AU  - Prandi LR
AD  - Boldrini Children's Center.
FAU - Omae, Cristiane
AU  - Omae C
AD  - Boldrini Children's Center.
FAU - Jotta, Patricia Y
AU  - Jotta PY
AD  - Boldrini Children's Center.
FAU - Pereira, Ricardo M
AU  - Pereira RM
AD  - Department of Pediatrics, Medical Sciences Faculty, State University of Campinas, 
      Campinas, SP, Brazil.
FAU - Brandalise, Silvia R
AU  - Brandalise SR
AD  - Boldrini Children's Center.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Pediatr Hematol Oncol
JT  - Journal of pediatric hematology/oncology
JID - 9505928
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Female
MH  - Humans
MH  - Leukemia, Promyelocytic, Acute/*mortality
MH  - Male
MH  - Retrospective Studies
EDAT- 2019/10/16 06:00
MHDA- 2020/12/31 06:00
CRDT- 2019/10/16 06:00
PHST- 2019/10/16 06:00 [pubmed]
PHST- 2020/12/31 06:00 [medline]
PHST- 2019/10/16 06:00 [entrez]
AID - 00043426-202010000-00031 [pii]
AID - 10.1097/MPH.0000000000001601 [doi]
PST - ppublish
SO  - J Pediatr Hematol Oncol. 2020 Oct;42(7):e641-e646. doi: 
      10.1097/MPH.0000000000001601.