Clinical Features and Hematological Investigations Pattern in Acute Promyelocytic Leukaemia Patients

Abstract

Background: Acute Promyelocytic Leukemia (AML-M3) patients, though amenable to treatment, present with early and
sometimes severe bleeding manifestations. In our setup, for various reasons, patients are diagnosed rather late and therefore
these bleeding manifestations are a limiting factor in the early and effective treatment of leukemia in such cases.
Objectives: To look into the clinical, peripheral blood and bone marrow features of AML-M3 patients in our setup.
Patients and Methods: A total of 40 consecutive cases of AML-M3 diagnosed on bone marrow biopsy over a period of 10
years were analyzed for clinico-morphological features.
Results: Majority of patients (75%) were <30 years of age. The male: female ratio was 3:2. The mean duration of symptoms
was 4.2 weeks (Range 1-10 weeks). Commonest clinical features were fever, pallor and bleeding manifestations. The spleen
and liver were variably enlarged in 25% and 45.5% of cases, respectively. The hemoglobin levels ranged from 3.1 to 12.8 g/dl
with a mean of 6.6 g/dl. The WBC count ranged from 0.5 to 142 x 109/l with a mean of 28.3 x 109/l. Platelet counts ranged
from 5-150 x 109/l with a mean of 28.8 x 109/l. Morphologically 36 patients had hypergranular and 4 had hypogranular
promyelocytic leukemia.
Conclusion: The features identified in our study can help in early diagnosis of APL, which is known to be extremely
important in effective management of patients.