Evaluating Outcomes in Acute Promyelocytic Leukemia Patients Treated with All-Trans-Retinoic Acid and Arsenic...

Acute promyelocytic leukemia (APML) is characterized by promyelocytic leukemia retinoic acid receptor alpha (PML-RARA) fusion gene resulting from at (15;17) translocation. The purpose of this study was to evaluate the clinical outcomes of patients with APML treated with a combination of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO), as well as to assess the diagnostic utility of flow cytometry (FCM) in this setting.This retrospective study was conducted from April 2021 to March 2024. Patients of either sex, aged 10 to 67 years, with APML were included in study. Patient history, symptom progression and lab parameters such as hemoglobin (Hb), total leucocytes count (TLC), and platelets count were extracted from medical records. A total of 45 patients with median age 33 years, with majority of female (55.6%) were included in study. The PML-RARA isoforms were detected in 97.8% patients, positive trait for bcr type 1 observed in 47.7% patients. Majority of patients (57.8%) were low risk type of APML. Most of patients show positive immunophenotype for CD117 (100%), CD33 (100%), MPO (94.7%), CD13 (97.7%) and CD64 (89.5%). Post treatment, complete remission was observed in 90% patients. The Hb levels significantly increased from baseline to last follow-up (7.7g/dL vs. 13.6 g/dL; P < .0001). Similarly, platelet count significantly increased from baseline to last follow-up (0.3 × 109/L vs. 2.6 × 109/L; P < 0.001). While, TLC significantly decreased from baseline in high risk cases to last follow-up (24 × 109/L vs. 9 × 109/L; P = 0.016). Patients with APML can be successfully treated with a combination of ATO and ATRA.