Outcome of a Real-Life Population of Patients With Acute Promyelocytic Leukemia Treated According to the PETHEMA Guidelines: The Polish Adult Leukemia Group (PALG) Experience
| Autor: | Miguel A. Sanz, Beata Piątkowska-Jakubas, Anna Skręt, Sebastian Grosicki, Grzegorz Charliński, Monika Podhorecka, Marzena Wątek, Aleksandra Gołos, Grzegorz Helbig, Marta Sobas, Monika Paluszewska, Anna Czyż, Sebastian Giebel, Agnieszka Pluta, Wojciech Miśkiewicz, Dorota Hawrylecka, Renata Guzicka-Kazimierczak, Agnieszka Wierzbowska, Pau Montesinos, Tomasz Wróbel, Ewa Zarzycka, Tomasz Gromek, Aleksandra Holowiecka, Jolanta Oleksiuk, Anna Armatys, David Martínez-Cuadrón, Maciej Majcherek, Krzysztof Lewandowski, Jadwiga Hołojda |
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| Rok vydání: | 2020 |
| Předmět: |
Acute promyelocytic leukemia
Adult Male Cancer Research medicine.medical_specialty Multivariate analysis Adolescent medicine.medical_treatment Population Early death Disease Favorable prognosis 03 medical and health sciences Young Adult 0302 clinical medicine Leukemia Promyelocytic Acute Risk Factors immune system diseases Internal medicine medicine Humans education neoplasms Aged Retrospective Studies Aged 80 and over Chemotherapy education.field_of_study business.industry Hematology Middle Aged medicine.disease Survival Analysis Leukemia ATRA Acute promyelocytic leukemia Chemotherapy Early death Outcome Treatment Outcome Oncology 030220 oncology & carcinogenesis Female Poland business 030215 immunology |
| Zdroj: | Clinical lymphoma, myeloma & leukemia r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname |
| ISSN: | 2152-2650 |
| Popis: | Background Acute promyelocytic leukemia (APL) has a favorable prognosis. However, results of randomized studies do not necessarily reflect the outcomes of a real-life population. Patients and Methods We analyzed 283 unselected APL patients treated in 20 Polish hospitals between 2005 and 2017. All patients were intended to be treated with PETHEMA (Programa Espanol para el Tratamiento de las Hemopatias Malignas) protocols based on all-trans retinoic acid plus chemotherapy. Results The probability of overall survival at 4 years was 67%, while event-free survival was 64%. The early death (ED) rate was 20.1% (n = 57), while 3.5% (n = 10) patients died before induction therapy was started. The main causes of ED included hemorrhage (45.6%), infections (17.5%), and differentiation syndrome (14.5%). Of 273 treated patients, 214 (78.4%) experienced hematologic morphologic remission, 2 (0.7%) were found to have resistant disease, 47 (17.2%) could not be evaluated for response because of ED, and in 6 (3.7%) no data concerning the response were available. Multivariate analyses showed that predictors of ED and overall survival were Eastern Cooperative Oncology Group performance status > 2, age > 60 years, and all types of bleeding episodes that occurred before starting therapy, while an additional predictor of event-free survival was high white blood cell count (> 10 109/L). Conclusion ED remains a major problem in APL patients, especially in a real-life population. Shortening of the time between the initial contact with a health care professional, and all-trans retinoic acid administration and the use of appropriate supportive care could improve the outcome of unselected APL population, mainly by reducing the ED rate. |
| Databáze: | OpenAIRE |
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