title: High dose ara-C in the treatment of newly diagnosed acute promyelocytic leukemia: long-term results of the German AMLCG.
abstract: The objective of this study for newly diagnosed acute promyelocytic leukemia (APL) was to evaluate the efficacy of an intensified double induction chemotherapy including high dose ara-C (HD) and all-trans retinoic acid (ATRA) followed by consolidation and 3 years maintenance therapy. In contrast to APL studies stratifying therapy according to pretreatment white blood cell (WBC) count < and > or =10 x 10(9)/l (low/intermediate and high risk according to the Sanz score), our patients received uniform therapy. From 1994 to 2005, 142 patients (age, 16-60 years) were enrolled. In the low/intermediate (n=105) vs high (n=37) WBC group, the rates of complete remission were 95.2 vs 83.8%, of induction death were 4.8 vs 16.2% (P=0.05) and of molecular remission were 87.5 vs 91.3% (P=1). Long-term overall survival was 84.4 vs 73.0% (P=0.12), event free survival was 78.3 vs 67.3% (P=0.11), relapse free survival was 82.1 vs 80.0% (P=0.83) and the cumulative incidence of relapse was 7.4 vs 11.4% (P=0.46). No relapse or death occurred after 4.7 years. ATRA and intensified chemotherapy including HD ara-C followed by prolonged maintenance therapy reduced the relapse risk in high risk patients. Pretreatment WBC count > or =10 x 10(9)/l count was no relevant prognostic factor for relapse.
authors.affiliation: III. Medizinische Universitätsklinik Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, Mannheim, Germany. eva.lengfelder@umm.de
authors.forename: E
authors.initials: E
authors.lastname: Lengfelder
authors.forename: C
authors.initials: C
authors.lastname: Haferlach
authors.forename: S
authors.initials: S
authors.lastname: Saussele
authors.forename: T
authors.initials: T
authors.lastname: Haferlach
authors.forename: B
authors.initials: B
authors.lastname: Schultheis
authors.forename: S
authors.initials: S
authors.lastname: Schnittger
authors.forename: W-D
authors.initials: WD
authors.lastname: Ludwig
authors.forename: P
authors.initials: P
authors.lastname: Staib
authors.forename: C
authors.initials: C
authors.lastname: Aul
authors.forename: A
authors.initials: A
authors.lastname: Grüneisen
authors.forename: W
authors.initials: W
authors.lastname: Kern
authors.forename: A
authors.initials: A
authors.lastname: Reichle
authors.forename: H
authors.initials: H
authors.lastname: Serve
authors.forename: W E
authors.initials: WE
authors.lastname: Berdel
authors.forename: J
authors.initials: J
authors.lastname: Braess
authors.forename: K
authors.initials: K
authors.lastname: Spiekermann
authors.forename: B
authors.initials: B
authors.lastname: Wörmann
authors.forename: M-C
authors.initials: MC
authors.lastname: Sauerland
authors.forename: A
authors.initials: A
authors.lastname: Heinecke
authors.forename: W
authors.initials: W
authors.lastname: Hiddemann
authors.forename: R
authors.initials: R
authors.lastname: Hehlmann
authors.forename: T
authors.initials: T
authors.lastname: Büchner
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003561:Cytarabine / Q000008:administration & dosage*; D005858:Germany; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000401:mortality; D008137:Longitudinal Studies; D018655:Lymphocyte Count; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction; D016019:Survival Analysis; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D003561:Cytarabine; D014212:Tretinoin