ACUTE PROMYELOCYTIC LEUKEMIA(APL)
Clinical features and course-case report from Romania
Ioana Virginia Popa and Ingrid Miron
Department of Pediatric Hemato-Oncology Disease
"St.Marry " Hospital
Background:
APL is one of the less frequent acute pediatric leukemias. Its course is less favourable regarding
the possible bleeding complications (DIC). The recent treatment possibilities like ATRA(acid
transretinoic) had demonstrated good efficency in prevention of DIC and in achiving complete
remission (CR).
Method:
We examined the case of a 11 years old girl who was admitted 1 year ago in our departament. This
child was submitted to therapy with ASTRA and DAT (Dexorubycyn, Aro-C and Thyoguanin cycles)
and is now at 1 year of CR
Results:
The course was complicated with frequent episodes of infection secondary to severe hematologic
toxicity post-chemothetapy. Surgical means were necessary when dissemination to subcutaneous
region of face appeared. CR losts for 12 months with a good life quality besides the post-surgical
cosmetic sequelle.
Discussions:
In Romania there is no possibility of immunofenotyping and genetics of blasts in order to make an
apropiate diagnosis which is usually established only by histopathology. Although treatment was
followed by a good CR, infections complications appeared as consequence of immunodepression
and local conditions
Conclusion:
APL is an entity with possibilities of treatment more feasible than other cases of non
lymphoblastic acute leukemia.
However, view the lack of accurate means of diagnosis at onset ruptures of
chemo-supplies and infections complications, prognosis is worse than in developed countries.
ivpopa@yahoo.com