Treatment of newly diagnosed acute promyelocytic leukemia (APL): a comparison of French-Belgian-Swiss and PETHEMA results Export

@article{citeulike:2580737, abstract = {All-trans retinoic acid (ATRA) plus anthracycline chemotherapy is the reference treatment of newly diagnosed acute promyelocytic leukemia (APL), whereas the role of cytosine arabinoside (AraC) remains disputed. We performed a joint analysis of patients younger than 65 years included in Programa para el Estudio de la Terapeutica en Hemopatia Maligna (PETHEMA) LPA 99 trial, where patients received no AraC in addition to ATRA, high cumulative dose idarubicin, and mitoxantrone, and APL 2000 trial, where patients received AraC in addition to ATRA and lower cumulative dose daunorubicin. In patients with white blood cell (WBC) count less than 10 x 109/L, complete remission (CR) rates were similar, but 3-year cumulative incidence of relapse (CIR) was significantly lower in LPA 99 trial: 4.2\% versus 14.3\% (P = .03), although 3-year survival was similar in both trials. This suggested that AraC is not required in APL with WBC count less than 10 x 109/L, at least in trials with high-dose anthracycline and maintenance treatment. In patients with WBC of 10 x 109/L or more, however, the CR rate (95.1\% vs 83.6\% P = .018) and 3-year survival (91.5\% vs 80.8\%, P = .026) were significantly higher in APL 2000 trial, and there was a trend for lower 3-year CIR (9.9\% vs 18.5\%, P = .12), suggesting a beneficial role for AraC in those patients. 10.1182/blood-2007-07-099978}, author = {Ades, Lionel and Sanz, Miguel A. and Chevret, Sylvie and Montesinos, Pau and Chevallier, Patrice and Raffoux, Emmanuel and Vellenga, Edo and Guerci, Agnes and Pigneux, Arnaud and Huguet, Francoise and Rayon, Consuelo and Stoppa, Anne M. and de La and Cahn, Jean-Yves and Meyer-Monard, Sandrine and Pabst, Thomas and Thomas, Xavier and de Botton, Stephane and Parody, Ricardo and Bergua, Juan and Lamy, Thierry and Vekhoff, Anne and Negri, Silvia and Ifrah, Norbert and Dombret, Herve and Ferrant, Augustin and Bron, Dominique and Degos, Laurent and Fenaux, Pierre}, citeulike-article-id = {2580737}, citeulike-linkout-0 = {http://dx.doi.org/10.1182/blood-2007-07-099978}, citeulike-linkout-1 = {http://bloodjournal.hematologylibrary.org/cgi/content/abstract/111/3/1078}, citeulike-linkout-2 = {http://view.ncbi.nlm.nih.gov/pubmed/17975017}, citeulike-linkout-3 = {http://www.hubmed.org/display.cgi?uids=17975017}, day = {1}, doi = {10.1182/blood-2007-07-099978}, journal = {Blood}, keywords = {apl}, month = {February}, number = {3}, pages = {1078--1084}, posted-at = {2008-03-24 14:29:34}, priority = {2}, title = {Treatment of newly diagnosed acute promyelocytic leukemia (APL): a comparison of French-Belgian-Swiss and PETHEMA results}, url = {http://dx.doi.org/10.1182/blood-2007-07-099978}, volume = {111}, year = {2008} }

TY - JOUR ID - citeulike:2580737 L3 - citeulike-article-id:2580737 N2 - All-trans retinoic acid (ATRA) plus anthracycline chemotherapy is the reference treatment of newly diagnosed acute promyelocytic leukemia (APL), whereas the role of cytosine arabinoside (AraC) remains disputed. We performed a joint analysis of patients younger than 65 years included in Programa para el Estudio de la Terapeutica en Hemopatia Maligna (PETHEMA) LPA 99 trial, where patients received no AraC in addition to ATRA, high cumulative dose idarubicin, and mitoxantrone, and APL 2000 trial, where patients received AraC in addition to ATRA and lower cumulative dose daunorubicin. In patients with white blood cell (WBC) count less than 10 x 109/L, complete remission (CR) rates were similar, but 3-year cumulative incidence of relapse (CIR) was significantly lower in LPA 99 trial: 4.2% versus 14.3% (P = .03), although 3-year survival was similar in both trials. This suggested that AraC is not required in APL with WBC count less than 10 x 109/L, at least in trials with high-dose anthracycline and maintenance treatment. In patients with WBC of 10 x 109/L or more, however, the CR rate (95.1% vs 83.6% P = .018) and 3-year survival (91.5% vs 80.8%, P = .026) were significantly higher in APL 2000 trial, and there was a trend for lower 3-year CIR (9.9% vs 18.5%, P = .12), suggesting a beneficial role for AraC in those patients. 10.1182/blood-2007-07-099978 IS - 3 JF - Blood EP - 1084 TI - Treatment of newly diagnosed acute promyelocytic leukemia (APL): a comparison of French-Belgian-Swiss and PETHEMA results VL - 111 SP - 1078 KW - apl AU - Ades, Lionel AU - Sanz, Miguel AU - Chevret, Sylvie AU - Montesinos, Pau AU - Chevallier, Patrice AU - Raffoux, Emmanuel AU - Vellenga, Edo AU - Guerci, Agnes AU - Pigneux, Arnaud AU - Huguet, Francoise AU - Rayon, Consuelo AU - Stoppa, Anne AU - de La AU - Cahn, Jean-Yves AU - Meyer-Monard, Sandrine AU - Pabst, Thomas AU - Thomas, Xavier AU - de Botton, Stephane AU - Parody, Ricardo AU - Bergua, Juan AU - Lamy, Thierry AU - Vekhoff, Anne AU - Negri, Silvia AU - Ifrah, Norbert AU - Dombret, Herve AU - Ferrant, Augustin AU - Bron, Dominique AU - Degos, Laurent AU - Fenaux, Pierre PY - 2008/02/01/ UR - http://dx.doi.org/10.1182/blood-2007-07-099978 ER -