Title |
Therapy-related acute promyelocytic leukemia: a systematic review
|
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Published in |
Medical Oncology, June 2013
|
DOI | 10.1007/s12032-013-0625-5 |
Pubmed ID | |
Authors |
Armin Rashidi, Stephen I. Fisher |
Abstract |
The incidence of therapy-related acute promyelocytic leukemia (t-APL) is apparently rising. We systematically reviewed the English literature until March 15, 2013, and collected a total of 326 t-APL cases, with the following results: (1) t-APL affects predominantly middle-aged adults with a median age at diagnosis of 47 years and a female-to-male ratio of 1.7:1; (2) after an incidence peak at 2 years following the completion of treatment for the primary antecedent disease, the risk of developing t-APL quickly diminishes with time; (3) the four most common primary antecedent conditions are breast cancer, hematological malignancies, multiple sclerosis, and genitourinary malignancies; (4) topoisomerase II inhibitors and radiation represent the most common potential risk factors; (5) despite different DNA damage "hot spot" sites, t-APL has no significant clinicopathologic differences from de novo APL (dn-APL); (6) t(15;17) is the sole cytogenetic abnormality in the vast majority of patients; (7) only a small minority of cases have a myelodysplastic or pancytopenic preleukemic phase; (8) more than one-third of patients come to medical attention incidentally (i.e., due to laboratory abnormalities), while the most common symptom is mucocutaneous bleeding, and 79 % have clinical DIC; and (9) the remission rate of t-APL is about 80 %, similar to dn-APL. |
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Geographical breakdown
Country | Count | As % |
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Spain | 2 | 4% |
Brazil | 1 | 2% |
Unknown | 54 | 95% |
Demographic breakdown
Readers by professional status | Count | As % |
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Researcher | 10 | 18% |
Student > Ph. D. Student | 7 | 12% |
Student > Master | 7 | 12% |
Student > Bachelor | 4 | 7% |
Professor | 3 | 5% |
Other | 8 | 14% |
Unknown | 18 | 32% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 24 | 42% |
Biochemistry, Genetics and Molecular Biology | 5 | 9% |
Agricultural and Biological Sciences | 4 | 7% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 4% |
Arts and Humanities | 1 | 2% |
Other | 3 | 5% |
Unknown | 18 | 32% |