ArticleFrontiers in medicine2026
Risk factors and management strategies in acute promyelocytic leukemia: a real-world single-center retrospective study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Acute promyelocytic leukemia (APL) has become a highly curable malignancy with the advent of targeted therapies. However, early death (ED), predominantly caused by severe hemorrhagic complications, continues to be the most significant obstacle to achieving high survival rates in real-world clinical practice, where outcomes often lag behind those reported in controlled trials. Aims: This retrospective study aimed to identify the key clinical and laboratory factors associated with ED and overall survival (OS) in a cohort of newly diagnosed APL patients. The study also sought to evaluate the impact of current supportive care strategies and identify opportunities for improved management. Methods: This single-center, retrospective analysis included 132 patients newly diagnosed with APL between June 2017 and January 2023. Data on demographics, baseline laboratory values, immunophenotyping, treatment, and outcomes were collected. Univariate and multivariate logistic regression analyses were used to identify independent predictors of ED, while Kaplan-Meier and Cox regression models were used to assess survival outcomes. Results: The ED rate was 12.88% (17 patients), with hemorrhage being the primary cause. Multivariate analysis identified three independent risk factors for ED: a high white blood cell (WBC) count (>201 × 10 Conclusions: This study found that high initial WBC count, prolonged PT, and CD2 positivity are critical independent predictors of ED in APL. The findings underscore the necessity of prompt diagnosis, risk-adapted therapy, and comprehensive multidisciplinary care, including aggressive management of coagulopathy. Enhanced CNS prophylaxis should be considered for high-risk patients to prevent relapse.
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