title: Early onset of chemotherapy can reduce the incidence of ATRA syndrome in newly diagnosed acute promyelocytic leukemia (APL) with low white blood cell counts: results from APL 93 trial.
abstract: Treatment combining ATRA and chemotherapy (CT) has improved the outcome of APL patients, by comparison with CT alone. ATRA syndrome is a life-threatening complication of ATRA treatment whose prophylaxis remains somewhat controversial. In APL93 trial, newly diagnosed APL patients </=65 years and with initial WBC counts below 5000/mm(3) were randomized between ATRA until CR achievement followed by CT (ATRA --> CT) and ATRA with early addition of CT, on day 3 of ATRA treatment (ATRA + CT). The incidence of ATRA syndrome in the ATRA --> CT arm was 18% (22/122) as compared to 9.2% (17/184) in the ATRA + CT arm (P = 0.035). In the ATRA --> CT arm, three (2.5%) patients died from ATRA syndrome, as compared to one (0.5%) in the ATRA + CT group. Early addition of chemotherapy to ATRA in newly diagnosed APL with low WBC counts significantly reduced the incidence of ATRA syndrome.
authors.forename: S
authors.initials: S
authors.lastname: de Botton
authors.forename: S
authors.initials: S
authors.lastname: Chevret
authors.forename: V
authors.initials: V
authors.lastname: Coiteux
authors.forename: H
authors.initials: H
authors.lastname: Dombret
authors.forename: M
authors.initials: M
authors.lastname: Sanz
authors.forename: J
authors.initials: J
authors.lastname: San Miguel
authors.forename: D
authors.initials: D
authors.lastname: Caillot
authors.forename: A
authors.initials: A
authors.lastname: Vekhoff
authors.forename: M
authors.initials: M
authors.lastname: Gardembas
authors.forename: A
authors.initials: A
authors.lastname: Stamatoulas
authors.forename: E
authors.initials: E
authors.lastname: Conde
authors.forename: A
authors.initials: A
authors.lastname: Guerci
authors.forename: C
authors.initials: C
authors.lastname: Gardin
authors.forename: M
authors.initials: M
authors.lastname: Fey
authors.forename: D
authors.initials: D
authors.lastname: Cony Makhoul
authors.forename: O
authors.initials: O
authors.lastname: Reman
authors.forename: J
authors.initials: J
authors.lastname: de la Serna
authors.forename: F
authors.initials: F
authors.lastname: Lefrere
authors.forename: C
authors.initials: C
authors.lastname: Chomienne
authors.forename: L
authors.initials: L
authors.lastname: Degos
authors.forename: P
authors.initials: P
authors.lastname: Fenaux
mesh_terms: D000328:Adult; D017668:Age of Onset; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000097:blood / Q000188:drug therapy*; D007958:Leukocyte Count; D007970:Leukopenia / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013577:Syndrome; D016896:Treatment Outcome; D014212:Tretinoin / Q000009:adverse effects* / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D014212:Tretinoin