Title:
|
Outcome of older (≥70 years) APL patients frontline treated with or without arsenic trioxide-an International Collaborative Study
|
Author:
|
Kayser, Sabine; Rahmé, Ramy; Martínez-Cuadrón, David; Ghiaur, Gabriel; Thomas, Xavier; Sobas, Marta; Guerci-Bresler, Agnes; Garrido, Ana; Pigneux, Arnaud; Gil, Cristina; Raffoux, Emmanuel; Tormo, Mar; Vey, Norbert; de la Serna, Javier; Salamero, Olga; Lengfelder, Eva; Levis, Mark; Fenaux, Pierre; Sanz, Miguel A..; Platzbecker, Uwe; Schlenk, Richard F.; Adès, Lionel; Montesinos, Pau; Universitat Autònoma de Barcelona
|
Abstract:
|
Data on outcome in older (≥70 years) patients with acute promyelocytic leukemia after treatment with arsenic trioxide (ATO) compared with standard chemotherapy (CTX) is scarce. We evaluated 433 patients (median age, 73.4 years) treated either with ATO+ all-trans retinoic acid (ATO/ATRA; n = 26), CTX/ATRA + ATO during consolidation (CTX/ATRA/ATO; n = 148), or with CTX/ATRA (n = 259). Median follow-up for overall survival (OS) was 4.8 years. Complete remissions (CR) were achieved in 92% with ATO/ATRA and 82% with CTX/ATRA; induction death rates were 8% and 18%, respectively. For analysis of postremission outcomes we combined the ATO/ATRA and CTX/ATRA/ATO groups (ATO/ATRA ± CTX). Cumulative incidence of relapse (CIR) was significantly lower after ATO/ATRA ± CTX compared with CTX/ATRA (P < 0.001). The same held true when restricting the analysis according to the treatment period after the year 2000. OS of patients in CR1 was not different between ATO/ATRA ± CTX compared with CTX/ATRA (P = 0.20). High (>10 × 10 9 /l) white blood cell (WBC) counts at diagnosis were associated with higher CIR (P < 0.001) compared with lower WBC in the CTX/ATRA group, but not in the ATO/ATRA ± CTX group (P = 0.48). ATO, when added to ATRA or CTX/ATRA is feasible and effective in elderly patients for remission induction and consolidation, particularly in patients with high WBC at diagnosis. |
Subject(s):
|
-Acute myeloid leukaemia -Clinical genetics |
Rights:
|
open access
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
https://creativecommons.org/licenses/by/4.0/ |
Document type:
|
Article |
Published by:
|
|
Share:
|
|
Uri:
|
https://ddd.uab.cat/record/248895
|