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@article{1399288,
author = {Kayser, S. and Krzykalla, J. and Elliott, M.A. and Norsworthy, K. and Gonzales, P. and Hills, R.K. and Baer, M.R. and Ráčil, Zdeněk and Mayer, Jiří and Novak, J. and Zak, P. and Szotkowski, T. and Grimwade, D. and Russell, N.H. and Walter, R.B. and Estey, E.H. and Westermann, J. and Gorner, M. and Benner, A. and Kramer, A. and Smith, B.D. and Burnett, A.K. and Thiede, C. and Rollig, C. and Ho, A.D. and Ehninger, G. and Schlenk, R.F. and Tallman, M.S. and Levis, M.J. and Platzbecker, U.},
article_location = {London},
article_number = {11},
doi = {http://dx.doi.org/10.1038/leu.2017.92},
keywords = {promyelocytic leukemia},
language = {eng},
issn = {0887-6924},
journal = {Leukemia},
title = {Characteristics and outcome of patients with therapy-related acute promyelocytic leukemia front-line treated with or without arsenic trioxide},
volume = {31},
year = {2017}
}
TY - JOUR
ID - 1399288
AU - Kayser, S. - Krzykalla, J. - Elliott, M.A. - Norsworthy, K. - Gonzales, P. - Hills, R.K. - Baer, M.R. - Ráčil, Zdeněk - Mayer, Jiří - Novak, J. - Zak, P. - Szotkowski, T. - Grimwade, D. - Russell, N.H. - Walter, R.B. - Estey, E.H. - Westermann, J. - Gorner, M. - Benner, A. - Kramer, A. - Smith, B.D. - Burnett, A.K. - Thiede, C. - Rollig, C. - Ho, A.D. - Ehninger, G. - Schlenk, R.F. - Tallman, M.S. - Levis, M.J. - Platzbecker, U.
PY - 2017
TI - Characteristics and outcome of patients with therapy-related acute promyelocytic leukemia front-line treated with or without arsenic trioxide
JF - Leukemia
VL - 31
IS - 11
SP - 2347-2354
EP - 2347-2354
PB - Nature Publishing Group
SN - 08876924
KW - promyelocytic leukemia
N2 - 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.
ER -
KAYSER, S., J. KRZYKALLA, M.A. ELLIOTT, K. NORSWORTHY, P. GONZALES, R.K. HILLS, M.R. BAER, Zdeněk RÁČIL, Jiří MAYER, J. NOVAK, P. ZAK, T. SZOTKOWSKI, D. GRIMWADE, N.H. RUSSELL, R.B. WALTER, E.H. ESTEY, J. WESTERMANN, M. GORNER, A. BENNER, A. KRAMER, B.D. SMITH, A.K. BURNETT, C. THIEDE, C. ROLLIG, A.D. HO, G. EHNINGER, R.F. SCHLENK, M.S. TALLMAN, M.J. LEVIS and U. PLATZBECKER. Characteristics and outcome of patients with therapy-related acute promyelocytic leukemia front-line treated with or without arsenic trioxide. \textit{Leukemia}. London: Nature Publishing Group, 2017, vol.~31, No~11, p.~2347-2354. ISSN~0887-6924. Available from: https://dx.doi.org/10.1038/leu.2017.92.
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