Impact of hepatitis C virus infection and blood cell parameters on acute promyelocytic leukemia outcome: a single center experience

Background Red blood cell distribution width, platelet distribution width, and mean platelet volume (MPV) were not studied in acute promyelocytic leukemia (APL) although; they were linked to prognosis of many malignancies. Additionally, hepatitis C virus (HCV) core protein is known to repeal the PML action however; the impact of HCV infection on APL outcome is unknown. Aims To study the characteristics of APL in Egyptian patients and impact of both HCV and routinely obtained blood cell parameters on APL outcome. Patients and methods We investigated retrospectively the correlation between red blood cells and platelets parameters and HCV infection in 65 APL Egyptian patients, from 2008 to 2017. Results Twenty percent of APL patients were HCV infected at time of diagnosis. HCV infected APL were older ( P =0.008), had high risk ( P =0.04), lower bone marrow promyelocytes %, serum albumin level, complete response rate, overall survival ( P =0.001, 0.002, 0.02, and 0.009, respectively), with median overall survival 1 month in comparison to 79.3 months in HCV non infected APL patients. Thrombosis (arterial and venous) was correlated significantly with low MPV ( P =0.001). Induction death occurred in 23 (35.3%) patients. Ten (25.6%) patients were relapsed and four of them were HCV infected. Conclusion HCV infected APL patients had poor prognosis. Also, low MPV was a potential biomarker for thrombosis in APL patients.