title: Late relapses in acute promyelocytic leukaemia.
abstract: From January 1988 to December 1997, among 53 acute promyelocytic leukaemia patients in 1st complete remission (CR) after 5 years from diagnosis, we observed 5 late relapses (9.4%) after 60, 61, 71, 101 and 155 months from diagnosis; 3 of those late relapses (7.7%) occurred among 39 patients previously treated with all-trans-retinoic acid. An involvement of the mastoid occurred in 3/5 patients (60%), compared with 2/32 patients (6.3%) at an early relapse (p < 0.02). As to the treatment of the late relapse, 1 patient received all-trans-retinoic acid alone followed by allogeneic transplantation and 4 patients were treated according to the GIMEMA 0191 protocol. All patients achieved a 2nd CR and are still alive: 4 in the 2nd molecular CR after 6, 33, 34 and 115 months; 1 relapsed after 15 months and is now in the 3rd CR. In conclusion, a late relapse occurred in a sizeable fraction of acute promyelocytic leukaemia patients: the high rate of ear involvement might be explained considering the ear as a 'disease sanctuary'.
authors.affiliation: Dipartimento di Biotecnologie Umane e Ematologia, Università La Sapienza, Roma, Italia. rob.lati@libero.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Latagliata
authors.forename: Ida
authors.initials: I
authors.lastname: Carmosino
authors.forename: Massimo
authors.initials: M
authors.lastname: Breccia
authors.forename: Antonio
authors.initials: A
authors.lastname: Minni
authors.forename: Anna
authors.initials: A
authors.lastname: Testi
authors.forename: Nicol
authors.initials: N
authors.lastname: Iorio
authors.forename: Francesco
authors.initials: F
authors.lastname: Lo-Coco
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Avvisati
authors.forename: Maria Concetta
authors.initials: MC
authors.lastname: Petti
authors.forename: Franco
authors.initials: F
authors.lastname: Mandelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cimino
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D015473:Leukemia, Promyelocytic, Acute / Q000473:pathology* / Q000628:therapy; D008297:Male; D008416:Mastoid / Q000473:pathology; D008942:Mitoxantrone / Q000008:administration & dosage; D012008:Recurrence; D013997:Time Factors; D014212:Tretinoin / Q000008:administration & dosage
chemical_list: D003561:Cytarabine; D014212:Tretinoin; D008942:Mitoxantrone; D015255:Idarubicin