Epidemiological characteristics analysis of acute promyelocytic leukemia in Henan Children's Hospital from 2017 to 2023

WANG Jin; WANG Gao-wei; WANG Mei-ye; ZHANG Zhen-hua; CHEN Jing

doi:10.13820/j.cnki.gdyx.20243399

Abstract：Objective To analyze the epidemiological characteristics of acute promyelocytic leukemia(APL)in children hospitalized at Henan Children's Hospital from 2017 to 2023,providing insights for the diagnosis and treatment of pediatric APL.Methods A retrospective study was conducted on pediatric patients initially diagnosed with acute mye-loid leukemia(AML)and admitted to the Hematology Oncology Department from January 2017 to December 2023.A total of 233 cases were selected,in which the PML/RARA fusion gene was detected using three methods:fluorescence in situ hybridization(FISH),reverse transcription-polymerase chain reaction(RT-PCR),and bone marrow karyotype analy-sis.The detection rates of these methods were compared.Additionally,gender distribution,seasonal incidence,age dis-tribution,and annual incidence rates of AML cases were analyzed.General parental information of APL patients was also recorded.Results Among the 233 AML cases,38 were diagnosed with APL.Both FISH and RT-PCR detected PML/RARA fusion genes in all 38 cases,with an accuracy rate of 100％,while bone marrow karyotype analysis identified t(15;17)chromosomal translocation in 34 cases,with an accuracy rate of 89.47％.The detection rates of the three meth-ods differed significantly(P＜0.05).The gender distribution among APL patients showed no significant difference(male:15.67％,female:17.17％,P＞0.05).The highest incidence was observed in children aged 6 to＜10 years(33.33％),followed by those aged≥10 years(23.53％),with the lowest incidence in children＜3 years old(3.85％),showing significant differences among age groups(P＜0.05).Seasonal incidence rates were as follows:spring(10.96％),summer(15.38％),autumn(12.33％),and winter(25.00％),with no significant seasonal varia-tion(P＞0.05).No significant differences were found in annual incidence rates from 2017 to 2023(P＞0.05).Among the parents of the 38 APL patients,the median paternal age at childbirth was 27 years,and the maternal age was 26 years.Natural conception occurred in 37 cases,with one case of in vitro fertilization.Four mothers had illnesses during pregnancy.Birth order distribution:firstborn(21 cases),second-born(13 cases),third-born(4 cases).Mode of delivery:vaginal birth(19 cases).Feeding methods:exclusive breastfeeding(31 cases),formula feeding(4 cases),mixed feeding(3 cases).Conclusion Among the three PML/RARA fusion gene detection methods,FISH and RT-PCR showed higher accuracy.The relatively high incidence of APL in children aged 6 to＜10 years suggests the need for increased clinical attention.