All-trans retinoic acid with daunorubicin or idarubicin for risk-adapted treatment of acute promyelocytic leukaemia: a matched-pair analysis of the PETHEMA LPA-2005 and IC-APL studies

Autor: Miguel A, Sanz, Pau, Montesinos, Haesook T, Kim, Guillermo J, Ruiz-Argüelles, María S, Undurraga, María R, Uriarte, Lem, Martínez, Rafael H, Jacomo, Homero, Gutiérrez-Aguirre, Raul A M, Melo, Rosane, Bittencourt, Ricardo, Pasquini, Katia, Pagnano, Evandro M, Fagundes, Edo, Vellenga, Alexandra, Holowiecka, Ana J, González-Huerta, Pascual, Fernández, Javier, De la Serna, Salut, Brunet, Elena, De Lisa, José, González-Campos, José M, Ribera, Isabel, Krsnik, Arnold, Ganser, Nancy, Berliner, Raul C, Ribeiro, Francesco, Lo-Coco, Bob, Löwenberg, Eduardo M, Rego, E, de Lisa
Přispěvatelé: Guided Treatment in Optimal Selected Cancer Patients (GUTS), Stem Cell Aging Leukemia and Lymphoma (SALL), Hematology
Rok vydání: 2015
Předmět:
Oncology
Male
medicine.medical_treatment
Risk-adapted therapy
Pharmacology
THERAPY
Leukemia
Promyelocytic
Acute
immune system diseases
Risk Factors
Antineoplastic Combined Chemotherapy Protocols
Cumulative incidence
Anthracyclines
Adolescent
Adult
Aged
Daunorubicin
Disease-Free Survival
Female
Humans
Idarubicin
Matched-Pair Analysis
Middle Aged
Treatment Outcome
Tretinoin
Young Adult
CONSOLIDATION
Promyelocytic
OUTCOMES
Leukemia
Cytarabine
Hematology
General Medicine
Cohort
medicine.drug
medicine.medical_specialty
Anthracycline
AGENT ARSENIC TRIOXIDE
Acute
Matched-pair analysis
Prognostic factors
Internal medicine
medicine
neoplasms
RESPONSE CRITERIA
Chemotherapy
business.industry
All-trans retinoic acid
QUIMIOTERÁPICOS
ANTHRACYCLINE
medicine.disease
Acute promyelocytic leukaemia
business
Settore MED/15 - Malattie del Sangue
Zdroj: ANNALS OF HEMATOLOGY
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname
Annals of Hematology, 94(8), 1347-1356. SPRINGER
r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual)
Universidade de São Paulo (USP)
instacron:USP
Annals of Hematology, 94(8), 1347-1356. Springer-Verlag
ISSN: 1432-0584
0939-5555
Popis: Front-line treatment of acute promyelocytic leukaemia (APL) consists of all-trans retinoic acid (ATRA) and anthracycline-based chemotherapy. In this setting, a comparison of idarubicin and daunorubicin has never been carried out. Two similar clinical trials using ATRA and chemotherapy for newly diagnosed APL were compared using matched-pair analysis. One was conducted by the PETHEMA/HOVON group with idarubicin and the other by the International Consortium on APL (IC-APL) using daunorubicin. Three hundred and fifty patients from the PETHEMA/HOVON cohort were matched with 175 patients in the IC-APL cohort, adjusting for the significantly unbalanced presenting features of the two entire cohorts. Complete remission (CR) rate was significantly higher in the PETHEMA/HOVON (94 %) than in the IC-APL cohort (85 %) (P = 0.002). The distribution of causes of induction failure and the time to achieve CR were similar in both cohorts. Patients who achieved CR had comparable cumulative incidence of relapse and disease-free survival rates, but lower overall and event-free survivals were observed in the IC-APL cohort, which was mainly due to a higher death rate during induction therapy. A higher death rate during consolidation therapy was also observed in the IC-APL. These results show that daunorubicin and idarubicin have similar antileukaemic efficacy in terms of primary resistance, molecular persistence, as well as molecular and haematological relapse rates when combined with ATRA in treatment of APL. However, a higher toxic death rate during induction and consolidation therapy was observed in the IC-APL cohort. This trial was registered at www.clinicaltrials.gov as #NCT00408278 [ClinicalTrials.gov].
Databáze: OpenAIRE
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