6533b85ffe1ef96bd12c1c8d

RESEARCH PRODUCT

Arsenic trioxide-based therapy of relapsed acute promyelocytic leukemia: registry results from the European LeukemiaNet

Francesco Lo-cocoMaria-cristina SauerlandMassimo BrecciaSebastian LehmannMaria PagoniA. M. NlogaPau MontesinosBhuvan KishoreWolf-k. HofmannLionel AdèsSafaa M. RamadanAnne SchmidtE. Di BonaJean-francois LambertDavid GrimwadeJose D. González-sanmiguelPierre FenauxA. J G HuertaEva LengfelderMiguel A. SanzDennis GörlichBruno Cassinat

subject

MaleCancer ResearchInternational CooperationGastroenterologyArsenicalsEuropean LeukemiaNetchemistry.chemical_compoundArsenic TrioxideLeukemia Promyelocytic AcuteRecurrence80 and overCumulative incidenceProspective StudiesRegistriesLeukocytosisArsenic trioxideChildAged 80 and overPromyelocyticLeukemiaCell DifferentiationOxidesHematologyMiddle AgedEuropeLeukemiaTreatment OutcomeOncologyChild PreschoolFemalemedicine.symptomAdultAcute promyelocytic leukemiamedicine.medical_specialtyAdolescentAntineoplastic AgentsAcuteDisease-Free SurvivalYoung AdultInternal medicinemedicineHumansAutologous transplantationPreschoolAgedbusiness.industrymedicine.diseaseSurgeryTransplantationAdolescent; Adult; Aged; Aged 80 and over; Antineoplastic Agents; Arsenicals; Cell Differentiation; Child; Child Preschool; Disease-Free Survival; Europe; Female; Humans; International Cooperation; Leukemia Promyelocytic Acute; Male; Middle Aged; Oxides; Prospective Studies; Recurrence; Registries; Treatment Outcome; Young AdultchemistrybusinessSettore MED/15 - Malattie del Sangue

description

In 2008, a European registry of relapsed acute promyelocytic leukemia was established by the European LeukemiaNet. Outcome data were available for 155 patients treated with arsenic trioxide in first relapse. In hematological relapse (n=104), 91% of the patients entered complete hematological remission (CR), 7% had induction death and 2% resistance, 27% developed differentiation syndrome and 39% leukocytosis, whereas no death or side effects occurred in patients treated in molecular relapse (n=40). The rate of molecular (m)CR was 74% in hematological and 62% in molecular relapse (P=0.3). All patients with extramedullary relapse (n=11) entered clinical and mCR. After 3.2 years median follow-up, the 3-year overall survival (OS) and cumulative incidence of second relapse were 68% and 41% in hematological relapse, 66% and 48% in molecular relapse and 90 and 11% in extramedullary relapse, respectively. After allogeneic or autologous transplantation in second CR (n=93), the 3-year OS was 80% compared with 59% without transplantation (n=55) (P=0.03). Multivariable analysis demonstrated the favorable prognostic impact of first remission duration ⩾1.5 years, achievement of mCR and allogeneic or autologous transplantation on OS of patients alive after induction (P=0.03, P=0.01, P=0.01) and on leukemia-free survival (P=0.006, P<0.0001, P=0.003), respectively.

https://doi.org/10.1038/leu.2015.12