Relationship between reticular fibrosis with platelet surface markers (CD41A, CD42A, CD42B, CD61) and prognostic markers (WBC, PLT) in acute promyelocytic leukemia

Introduction: Acute promyelocytic leukemia is a type of leukemia in which abnormal promyelocytes predominate in the peripheral blood and bone marrow. Its clinical course and treatment differ from those of other acute myeloid leukemias. It is necessary to elucidate bone marrow fibrosis in acute promyelocytic leukemia. Material and methods: Our study included 44 patients who were followed up and treated for acute promyelocytic leukemia in the adult hematology clinic of Turgut Özal Medical Center, Malatya, Türkiye. The relationship between CD 41A, CD 42A, CD 42B, and CD61 levels in flow cytometry and prognostic markers (WBC, PLT) was studied at diagnosis, and the fibrosis grade in the bone marrow pathology taken at diagnosis was examined. Results: The relationship between the fibrosis grade in bone marrow biopsy at diagnosis and PLT, WBC, CD41A, CD42A, CD42B and CD61 values was statistically insignificant (p > 0.05). There was no statistical difference between genders according to fibrosis results in bone marrow biopsy at diagnosis (p > 0.05). There was a statistically significant age difference (p < 0.05). At the time of diagnosis, the bone marrow fibrosis grade of 12 patients was found to be 2 or higher. We observed an increase in the fibrosis grade in bone marrow in three patients, a decrease in fibrosis in five patients, and no change in the fibrosis grade in six patients after treatment. There was no relationship between platelet surface markers and risk groups during the diagnosis of acute promyelocytic leukemia. While no correlation was detected between disseminated intravascular coagulation and platelet surface markers after treatment, a negative correlation was observed with pre-treatment INR. Conclusions: Reticular fibrosis may be seen in patients diagnosed with acute promyelocytic leukemia. The cause of reticular fibrosis is unclear. Elevation of flow cytometric platelet surface markers in blasts at diagnosis are not directly related to reticular fibrosis. There are conflicting results in the regression of reticular fibrosis after treatment.