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@ARTICLE{Kayser:130805,
author = {S. Kayser$^*$ and J. Krzykalla$^*$ and M. A. Elliott and K.
Norsworthy and P. Gonzales and R. K. Hills and M. R. Baer
and Z. Ráčil and J. Mayer and J. Novak and P. Žák and T.
Szotkowski and D. Grimwade and N. H. Russell and R. B.
Walter and E. H. Estey and J. Westermann and M. Görner and
A. Benner$^*$ and A. Krämer$^*$ and B. D. Smith and A. K.
Burnett and C. Thiede and C. Röllig and A. D. Ho and G.
Ehninger and R. Schlenk$^*$ and M. S. Tallman and M. J.
Levis and U. Platzbecker},
title = {{C}haracteristics and outcome of patients with
therapy-related acute promyelocytic leukemia front-line
treated with or without arsenic trioxide.},
journal = {Leukemia},
volume = {31},
number = {11},
issn = {1476-5551},
address = {Basingstoke},
publisher = {Nature Publ. Group},
reportid = {DKFZ-2017-05883},
pages = {2347 - 2354},
year = {2017},
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.},
cin = {G330 / C060 / G040},
ddc = {610},
cid = {I:(DE-He78)G330-20160331 / I:(DE-He78)C060-20160331 /
I:(DE-He78)G040-20160331},
pnm = {317 - Translational cancer research (POF3-317)},
pid = {G:(DE-HGF)POF3-317},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:28322237},
doi = {10.1038/leu.2017.92},
url = {https://inrepo02.dkfz.de/record/130805},
}