Risk-adapted treatment of acute promyelocytic leukemia with all-trans retinoic acid and anthracycline monochemotherapy: long-term outcome of the LPA 99 multicenter study by the PETHEMA Group.
A previous report of the Programa de Estudio y Tratamiento de las Hemopatías Malignas (PETHEMA) Group showed that a risk-adapted strategy combining all-trans retinoic acid (ATRA) and anthracycline monochemotherapy for induction and consolidation in newly diagnosed acute promyelocytic leukemia results in an improved outcome. Here we analyze treatment outcome of an enlarged series of patients who have been followed up for a median of 65 months. From November 1999 through July 2005 (LPA99 trial), 560 patients received induction therapy with ATRA plus idarubicin. Patients achieving complete remission received 3 courses of consolidation followed by maintenance with ATRA and low-dose chemotherapy. The 5-year cumulative incidence of relapse and disease-free survival were 11% and 84%, respectively. These results compare favorably with those obtained in the previous LPA96 study (P = .019 and P = .04, respectively). This updated analysis confirms the high antileukemic efficacy, low toxicity, and high degree of compliance of a risk-adapted strategy combining ATRA and anthracycline monochemotherapy for consolidation therapy.
Sanz
Miguel A
MA
Hospital Universitario La Fe, Valencia, Spain. msanz@uv.es
Montesinos
Pau
P
Vellenga
Edo
E
Rayón
Consuelo
C
de la Serna
Javier
J
Parody
Ricardo
R
Bergua
Juan M
JM
León
Angel
A
Negri
Silvia
S
González
Marcos
M
Rivas
Concha
C
Esteve
Jordi
J
Milone
Gustavo
G
González
José D
JD
Amutio
Elena
E
Brunet
Salut
S
García-Laraña
J
J
Colomer
Dolors
D
Calasanz
María J
MJ
Chillón
Carmen
C
Barragán
Eva
E
Bolufer
Pascual
P
Lowenberg
Bob
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome; D014212:Tretinoin / Q000627:therapeutic use*
D018943:Anthracyclines; D000970:Antineoplastic Agents; D014212:Tretinoin