Characteristics and outcome of patients with low-/intermediate-risk acute promyelocytic leukemia treated with arsenic trioxide: an international collaborative study.
Journal
Haematologica
ISSN: 1592-8721
Titre abrégé: Haematologica
Pays: Italy
ID NLM: 0417435
Informations de publication
Date de publication:
01 12 2021
01 12 2021
Historique:
received:
06
03
2021
pubmed:
29
5
2021
medline:
1
4
2022
entrez:
28
5
2021
Statut:
epublish
Résumé
The aim of this study was to characterize a large series of 154 patients with acute promyelocytic leukemia (median age, 53 years; range, 18-90 years) and evaluate real-life outcome after up-front treatment with arsenic trioxide and all-trans retinoic acid. All patients were included in the prospective NAPOLEON registry (NCT02192619) between 2013 and 2019. The acute promyelocytic leukemia was de novo in 91% (n=140) and therapy-related in 9% (n=14); 13% (n=20) of the patients were older than 70 years. At diagnosis bleeding/hemorrhage was present in 38% and thrombosis in 3%. Complete remission was achieved in 152 patients (99%), whereas two patients (1%) experienced induction death within 18 days after starting therapy. With a median follow-up of 1.99 years (95% confidence interval: 1.61-2.30 years) 1-year and 2-year overall survival rates were 97% (95% confidence interval: 94-100%) and 95% (95% confidence interval: 91-99%), respectively. Age above 70 years was associated with a significantly shorter overall survival (P<0.001) compared to that of younger patients. So far no relapses have been observed. Six patients (4%) died in complete remission at a median of 0.95 years after diagnosis (range, 0.18-2.38 years). Our data confirm the efficiency and durability of arsenic trioxide and all-trans retinoic acid therapy in the primary management of adults with low-/intermediate-risk acute promyelocytic leukemia in the real-life setting, irrespective of age.
Identifiants
pubmed: 34047178
doi: 10.3324/haematol.2021.278722
pmc: PMC8634174
doi:
Substances chimiques
Tretinoin
5688UTC01R
Arsenic Trioxide
S7V92P67HO
Banques de données
ClinicalTrials.gov
['NCT02192619']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3100-3106Commentaires et corrections
Type : CommentIn
Références
Blood Rev. 2018 Mar;32(2):89-95
pubmed: 29033137
J Clin Oncol. 2011 Jul 10;29(20):2753-7
pubmed: 21646615
Ann Intern Med. 1985 Oct;103(4):620-5
pubmed: 3862359
Blood. 2011 Aug 4;118(5):1248-54
pubmed: 21653939
Med Oncol. 2000 Nov;17(4):307-13
pubmed: 11114710
Leukemia. 1997 Sep;11(9):1447-52
pubmed: 9305596
Best Pract Res Clin Haematol. 2014 Mar;27(1):3-9
pubmed: 24907012
Leukemia. 2014 Dec;28(12):2422-4
pubmed: 25142818
Leuk Res. 2013 Nov;37(11):1451-6
pubmed: 23958062
Leuk Res. 2010 Mar;34(3):403-5
pubmed: 19733394
Leukemia. 1997 Oct;11(10):1605-9
pubmed: 9324277
Lancet Oncol. 2015 Oct;16(13):1295-305
pubmed: 26384238
Leukemia. 2020 Sep;34(9):2333-2341
pubmed: 32076120
Blood. 2008 Apr 1;111(7):3395-402
pubmed: 18195095
Cancer. 2003 Sep 15;98(6):1206-16
pubmed: 12973844
Leukemia. 2005 Jun;19(6):978-83
pubmed: 15843821
N Engl J Med. 2013 Jul 11;369(2):111-21
pubmed: 23841729
Semin Hematol. 2002 Apr;39(2 Suppl 1):3-7
pubmed: 12012315
Haematologica. 2010 Mar;95(3):424-31
pubmed: 19903674
Leukemia. 2017 Jun;31(6):1457-1459
pubmed: 28232742
Blood. 2019 Apr 11;133(15):1630-1643
pubmed: 30803991
Cancer. 2013 Jan 1;119(1):115-25
pubmed: 22930197
J Clin Oncol. 2010 Aug 20;28(24):3872-9
pubmed: 20625122
Control Clin Trials. 1996 Aug;17(4):343-6
pubmed: 8889347
Ann Hematol. 2014 Dec;93(12):2001-10
pubmed: 24981688
Leukemia. 2018 Jun;32(6):1277-1294
pubmed: 29743722
Blood. 2010 Oct 28;116(17):3171-9
pubmed: 20644121
Blood. 2010 Nov 11;116(19):3751-7
pubmed: 20705755
Br J Haematol. 2000 Dec;111(3):801-6
pubmed: 11122141
Br J Haematol. 2014 Sep;166(5):660-6
pubmed: 24780059
J Clin Oncol. 2017 Feb 20;35(6):605-612
pubmed: 27400939
Cancers (Basel). 2019 Oct 18;11(10):
pubmed: 31635329
J Clin Oncol. 2003 Dec 15;21(24):4642-9
pubmed: 14673054
Blood. 2002 Aug 15;100(4):1514-5
pubmed: 12184278
Leukemia. 2002 Nov;16(11):2185-9
pubmed: 12399960
Leuk Lymphoma. 2014 Jul;55(7):1523-32
pubmed: 24160850
Blood. 2016 Sep 15;128(11):1525-8
pubmed: 27402972
Blood. 2002 Jun 15;99(12):4326-35
pubmed: 12036858
Proc Natl Acad Sci U S A. 2009 Mar 3;106(9):3342-7
pubmed: 19225113
Ann Hematol. 2016 Apr;95(5):673-80
pubmed: 26920716
Leukemia. 2016 Oct;30(10):1987-1992
pubmed: 27133819