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Very long-term outcome of acute promyelocytic leukemia after treatment with all-trans retinoic acid and chemotherapy : the European APL Group experience

Adès, Lionel and Guerci, Agnes and Raffoux, Emmanuel and Sanz, Miguel and Chevallier, Patrice and Lapusan, Simona and Recher, Christian and Thomas, Xavier and Rayon, Consuelo and Castaigne, Sylvie and Tournilhac, Olivier and de Botton, Stephane and Ifrah, Norbert and Cahn, Jean-Yves and Solary, Eric and Gardin, Claude and Fegeux, Nathalie and Bordessoule, Dominique and Ferrant, Augustin and Meyer-Monard, Sandrine and Vey, Norbert and Dombret, Herve and Degos, Laurent and Chevret, Sylvie and Fenaux, Pierre and European APL Group, . (2010) Very long-term outcome of acute promyelocytic leukemia after treatment with all-trans retinoic acid and chemotherapy : the European APL Group experience. Blood, Vol. 115, H. 9. pp. 1690-1696.

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Official URL: http://edoc.unibas.ch/dok/A6006536

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Abstract

Acute promyelocytic leukemia (APL) is highly curable with the combination of all-trans retinoic acid (ATRA) and anthracycline-based chemotherapy (CT), but very long-term results of this treatment, when CT should be added to ATRA and the role of maintenance treatment, remain uncertain. In our APL93 trial that included 576 newly diagnosed APL patients, with a median follow-up of 10 years, 10-year survival was 77%. Maintenance treatment significantly reduced 10-year cumulative incidence of relapses, from 43.2% to 33%, 23.4%, and 13.4% with no maintenance, maintenance using intermittent ATRA, continuous 6 mercaptopurine plus methotrexate, and both treatments, respectively (P > .001). Maintenance particularly benefited patients with white blood cell (WBC) count higher than 5 x 10(9)/L (5000/microL). Early addition of CT to ATRA significantly improved 10-year event-free survival (EFS), but without significant effect on overall survival (OS). The 10-year cumulative incidence of deaths in complete response (CR), resulting mainly from myelosuppression, was 5.7%, 15.4%, and 21.7% in patients younger than 55, 55 to 65, and older than 65 years, respectively, supporting the need for less myelosuppressive treatments, particularly for consolidation therapy. This study is registered at http://clinicaltrials.gov as NCT00599937.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Hämatologie > Hämatologie (Passweg)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Hämatologie > Hämatologie (Passweg)
UniBasel Contributors:Meyer-Monard, Sandrine
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:American Society of Hematology
ISSN:1528-0020
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:24 May 2013 09:14
Deposited On:26 Apr 2013 07:01

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