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Inclusion of hemoglobin level in prognostic score provides better prognostic stratification in patients with acute promyelocytic leukemia (APL)

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Abstract

The clinical outcomes of acute promyelocytic leukemia (APL) have improved greatly, but treatment failure still occurs. Identification of patients with poor prognosis is fundamental, and we propose a new clinical prognostic system (CBC-score) consisting of WBC, platelet count, and hemoglobin level. Between 1995 and 2009, 156 patients with APL from seven institutes in Korea were retrospectively reviewed. In the new CBC-score system, each of the following (WBC ≥10 × 109/L, platelet <40 × 109/L, hemoglobin <8.0 g/dL) was considered as a risk factor; the sum of each was designated as the CBC-score. With a median follow-up of 8.4 years, the complete remission (CR) rate was 81.4 % (127/156), while 24 (15.4 %) were considered as treatment failures due to early death (ED). The 5-year overall survival (OS), leukemia-free survival, and cumulative incidence of relapse were 73.8, 82.8, and 13.5 %, respectively. Compared to the individual CBC parameters, combined prognostic systems such as PETHEMA or CBC-score provided better prognostic stratification. Compared to PETHEMA stratification, the proposed prognostic CBC-score system showed better stratification of APL patients in terms of CR rates (p = 0.004), OS (p = 0.004), and ED (p = 0.008). This retrospective study suggests that the proposed CBC-score may provide better prognostic stratification of APL patients.

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Conflict of interest

None of the listed authors declare any conflict of interest.

Author information

Authors and Affiliations

  1. Division of Hematology-Oncology, Department of Medicine, Samsung Meidical Center, Sungkyunkwan University School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea

    Silvia Park, Su Jin Lee, Kihyun Kim, Jun Ho Jang, Dong Hwan Kim & Chul Won Jung

  2. Asan Medical Center, Seoul, Korea

    Kyu Hyung Lee, Je Hwan Lee, Jung Hee Lee & Dae Young Kim

  3. Hanlym University Hospital, Seoul, Korea

    Dae-Young Jang

  4. Ulsan University Hospital, Ulsan, Korea

    Hawk Kim & Jae Hoo Park

  5. Catholic University Hospital, Daegu, Korea

    Hun Mo Ryoo & Sung Hwa Bae

  6. Youngnam University Hospital, Daegu, Korea

    Min Kyung Kim & Myung Soo Hyun

  7. Paik Busan Hospital, Busan, Korea

    Young Don Joo, Won Sik Lee & Sang Min Lee

Authors
  1. Silvia Park
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  2. Su Jin Lee
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  3. Kihyun Kim
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  4. Jun Ho Jang
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  5. Dong Hwan Kim
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  6. Kyu Hyung Lee
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  7. Je Hwan Lee
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  8. Jung Hee Lee
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  9. Dae Young Kim
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  11. Hawk Kim
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  12. Jae Hoo Park
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  13. Hun Mo Ryoo
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  15. Min Kyung Kim
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  18. Won Sik Lee
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  19. Sang Min Lee
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  20. Chul Won Jung
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Corresponding author

Correspondence to Chul Won Jung.

Additional information

S. Park and S. J. Lee contributed equally to this work.

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Park, S., Lee, S.J., Kim, K. et al. Inclusion of hemoglobin level in prognostic score provides better prognostic stratification in patients with acute promyelocytic leukemia (APL). Int J Hematol 97, 388–396 (2013). https://doi.org/10.1007/s12185-013-1276-1

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  • DOI: https://doi.org/10.1007/s12185-013-1276-1

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