Abstract:
:All-trans-retinoic acid (ATRA) combined with anthracyclines is currently the standard treatment for acute promyelocytic leukemia (APL). In elderly patients the presence of comorbidities, such as cardiomyopathy or different organ failures, often represents an absolute contraindication to standard chemotherapy. In this particular setting of patients, alternative front-line approaches are needed. Here we report the use of gemtuzumab ozogamicin as consolidation therapy in a 68-year-old patient not eligible for standard dose anthracycline due to severe cardiac failure and chronic anticoagulant therapy, affected by low-risk APL. Induction therapy was started with ATRA alone, at a dose of 45 mg/m2 for 80 days. The patient obtained a complete hematological and molecular remission. At day +170 the patient was treated with 6 mg/m2 gemtuzumab ozogamicin monthly for two months (2 total doses) as a consolidation therapy and then started a maintenance program with ATRA 45 mg/m2 for 15 days every three months, for a total time of two years. No adverse events were observed in every phase of treatment and the patient is still in complete continuous hematological and molecular remission 29 months from diagnosis. This approach represents an intriguing therapeutic option to be investigated in randomized studies in low- and intermediate-risk elderly patients (older than 65 years), aiming to minimize or to eliminate standard chemotherapy in advantage of new non-conventional agents, including ATO.
journal_name
Acta Haematoljournal_title
Acta haematologicaauthors
Finizio O,Pezzullo L,Rocco S,Bene L,De Rosa C,Nunziata GR,Mettivier Vdoi
10.1159/000097880subject
Has Abstractpub_date
2007-01-01 00:00:00pages
188-90issue
3eissn
0001-5792issn
1421-9662pii
000097880journal_volume
117pub_type
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journal_title:Acta haematologica
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pub_type: 临床试验,杂志文章
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journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000205392
更新日期:1989-01-01 00:00:00
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journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000205983
更新日期:1987-01-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章
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更新日期:1976-01-01 00:00:00
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更新日期:1976-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1159/000058318
更新日期:2002-01-01 00:00:00