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Characteristics and outcome of patients with low-/intermediate-risk acute promyelocytic leukemia treated with arsenic trioxide - an international collaborative study

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Item Type:Article
Title:Characteristics and outcome of patients with low-/intermediate-risk acute promyelocytic leukemia treated with arsenic trioxide - an international collaborative study
Creators Name:Kayser, S. and Schlenk, R.F. and Lebon, D. and Carre, M. and Götze, K.S. and Stölzel, F. and Berceanu, A. and Schäfer-Eckart, K. and Peterlin, P. and Hicheri, Y. and Rahme, R. and Raffoux, E. and Chermat, F. and Krause, S.W. and Aulitzky, W.E. and Rigaudeau, S. and Noppeney, R. and Berthon, C. and Görner, M. and Jost, E. and Carassou, P. and Keller, U. and Orvain, C. and Braun, T. and Saillard, C. and Arar, A. and Kunzmann, V. and Wemeau, M. and De Wit, M. and Niemann, D. and Bonmati, C. and Schwänen, C. and Abraham, J. and Aljijakli, A. and Haiat, S. and Krämer, A. and Reichle, A. and Gnadler, M. and Willekens, C. and Spiekermann, K. and Hiddemann, W. and Müller-Tidow, C. and Thiede, C. and Röllig, C. and Serve, H. and Bornhäuser, M. and Baldus, C.D. and Lengfelder, E. and Fenaux, P. and Platzbecker, U. and Adès, L.
Abstract:The aim of this study was to characterize a large series of 154 patients with acute promyelocytic leukemia (APL; median age, 53 years; range, 18-90 years) and evaluate real-life outcome after up-front treatment with arsenic trioxide (ATO) and alltrans retinoic acid (ATRA). All patients were included in the prospective NAPOLEON registry (NCT02192619) between 2013 and 2019. APL was de novo in 91% (n=140) and therapy-related in 9% (n=14); 13% (n=20) were older than 70 years. At diagnosis bleeding/hemorrhage was present in 38% and thrombosis in 3%. Complete remission was achieved in 152 patients (99%), whereas two patients (1%) experienced induction death within 18 days after start of therapy. With a median follow-up of 1.99 years (95%-CI, 1.61-2.30 years) 1-year and 2-years overall survival (OS) rates were 97% (95%-CI, 94-100%) and 95% (95%-CI, 91-99%), respectively. Age above 70 years was associated with a significantly shorter OS (P<0.001) as compared to younger patients. So far no relapses were observed. Six patients (4%) died in CR after in median 0.95 years after diagnosis (range, 0.18-2.38 years). Our data confirm the efficiency and durability of ATO/ATRA in the primary management of adult low-/ intermediate-risk APL patients in the real life setting, irrespective of age.
Keywords:Acute Promyelocytic Leukemia, ATO/ATRA, Outcome
Source:Haematologica
ISSN:0390-6078
Publisher:Ferrata Storti Foundation
Volume:106
Number:12
Page Range:3100-3106
Date:December 2021
Official Publication:https://doi.org/10.3324/haematol.2021.278722
PubMed:View item in PubMed

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