Journal Article

DKFZ-2017-05883

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Characteristics and outcome of patients with therapy-related acute promyelocytic leukemia front-line treated with or without arsenic trioxide.

Kayser, S. (First author)DKFZ* ; Krzykalla, J.DKFZ* ; Elliott, M. A. ; Norsworthy, K. ; Gonzales, P. ; Hills, R. K. ; Baer, M. R. ; Ráčil, Z. ; Mayer, J. ; Novak, J. ; Žák, P. ; Szotkowski, T. ; Grimwade, D. ; Russell, N. H. ; Walter, R. B. ; Estey, E. H. ; Westermann, J. ; Görner, M. ; Benner, A.DKFZ* ; Krämer, A.DKFZ* ; Smith, B. D. ; Burnett, A. K. ; Thiede, C. ; Röllig, C. ; Ho, A. D. ; Ehninger, G. ; Schlenk, R.DKFZ* ; Tallman, M. S. ; Levis, M. J. ; Platzbecker, U.

2017
Nature Publ. Group Basingstoke

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Please use a persistent id in citations: doi:10.1038/leu.2017.92

Abstract: Therapy-related acute promyelocytic leukemia (t-APL) is relatively rare, with limited data on outcome after treatment with arsenic trioxide (ATO) compared to standard intensive chemotherapy (CTX). We evaluated 103 adult t-APL patients undergoing treatment with all-trans retinoic acid (ATRA) alone (n=7) or in combination with ATO (n=24), CTX (n=53), or both (n=19). Complete remissions were achieved after induction therapy in 57% with ATRA, 100% with ATO/ATRA, 78% with CTX/ATRA, and 95% with CTX/ATO/ATRA. Early death rates were 43% for ATRA, 0% for ATO/ATRA, 12% for CTX/ATRA and 5% for CTX/ATO/ATRA. Three patients relapsed, two developed therapy-related acute myeloid leukemia and 13 died in remission including seven patients with recurrence of the prior malignancy. Median follow-up for survival was 3.7 years. None of the patients treated with ATRA alone survived beyond one year. Event-free survival was significantly higher after ATO-based therapy (95%, 95% CI, 82-99%) as compared to CTX/ATRA (78%, 95% CI, 64-87%; P=0.042), if deaths due to recurrence of the prior malignancy were censored. The estimated 2-year overall survival in intensively treated patients was 88% (95% CI, 80-93%) without difference according to treatment (P=0.47). ATO when added to ATRA or CTX/ATRA is feasible and leads to better outcomes as compared to CTX/ATRA in t-APL.

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Contributing Institute(s):

1. KKE Molekulare Hämatologie/Onkologie (G330)
2. Biostatistik (C060)
3. Klinische Studienzentrale (G040)

Research Program(s):

1. 317 - Translational cancer research (POF3-317) (POF3-317)

Appears in the scientific report 2017

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Database coverage:
; BIOSIS Previews ; Current Contents - Life Sciences ; Ebsco Academic Search ; IF >= 10 ; JCR ; NCBI Molecular Biology Database ; SCOPUS ; Science Citation Index ; Science Citation Index Expanded ; Thomson Reuters Master Journal List ; Web of Science Core Collection

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