Improved prevention and treatment strategies for differentiation syndrome contribute to reducing early mortality in patients with acute promyelocytic leukemia
Qian Wu, Xiaofei Yang, Jing-Ren Zhang, Mengxing Xue, Xueqing Dou, Zheng Ge, Yifei Chen, Weiying Gu, Weimin Dong, Hongying Cao, Naike Jiang, Xuemei Sun, Zefa Liu, Jinning Shi, Hui Chen, Cixian Zhang, Fengling Min, Hongli Sun, Xiaoli Qian, Hongjian Yuan, Yuan Feng, Depei Wu, Suning Chen
Abstract
With the introduction of differentiating agents, such as all-trans retinoic acid (ATRA) and arsenic trioxide (ATO), the outcomes of patients with acute promyelocytic leukemia (APL) have significantly improved [ 1 , 2 ]. However, there are still many early deaths, especially among those at high risk [ 3 , 4 ]. In our retrospective study of 570 patients with APL, early mortality was 7.54% [ 5 ]. We observed unexpected and preventable early deaths, mainly caused by steroid-unresponsive differentiation syndrome (DS) and lethal hemorrhage.