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Outcome of older (≥70 years) APL patients frontline treated with or without arsenic trioxide-an International Collaborative Study.

Abstract：

:Data on outcome in older (≥70 years) patients with acute promyelocytic leukemia after treatment with arsenic trioxide (ATO) compared with standard chemotherapy (CTX) is scarce. We evaluated 433 patients (median age, 73.4 years) treated either with ATO+ all-trans retinoic acid (ATO/ATRA; n = 26), CTX/ATRA + ATO during consolidation (CTX/ATRA/ATO; n = 148), or with CTX/ATRA (n = 259). Median follow-up for overall survival (OS) was 4.8 years. Complete remissions (CR) were achieved in 92% with ATO/ATRA and 82% with CTX/ATRA; induction death rates were 8% and 18%, respectively. For analysis of postremission outcomes we combined the ATO/ATRA and CTX/ATRA/ATO groups (ATO/ATRA ± CTX). Cumulative incidence of relapse (CIR) was significantly lower after ATO/ATRA ± CTX compared with CTX/ATRA (P < 0.001). The same held true when restricting the analysis according to the treatment period after the year 2000. OS of patients in CR1 was not different between ATO/ATRA ± CTX compared with CTX/ATRA (P = 0.20). High (>10 × 109/l) white blood cell (WBC) counts at diagnosis were associated with higher CIR (P < 0.001) compared with lower WBC in the CTX/ATRA group, but not in the ATO/ATRA ± CTX group (P = 0.48). ATO, when added to ATRA or CTX/ATRA is feasible and effective in elderly patients for remission induction and consolidation, particularly in patients with high WBC at diagnosis.

journal_name

Leukemia

journal_title

Leukemia

authors

Kayser S,Rahmé R,Martínez-Cuadrón D,Ghiaur G,Thomas X,Sobas M,Guerci-Bresler A,Garrido A,Pigneux A,Gil C,Raffoux E,Tormo M,Vey N,de la Serna J,Salamero O,Lengfelder E,Levis MJ,Fenaux P,Sanz MA,Platzbecker U,Schlen

doi

10.1038/s41375-020-0758-4

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

2333-2341

issue

9

eissn

0887-6924

issn

1476-5551

pii

10.1038/s41375-020-0758-4

journal_volume

34

pub_type

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