title: Treatment of Acute Promyelocytic Leukemia with AIDA Based Regimen. Update of a Tunisian Single Center Study.
abstract: In Tunisia, the ATRA era began in 1998 with the use, consecutively, of two regimens combining ATRA and an anthracycline with cytarabine (APL93), and without cytarabine (LPA99). From 2004, 51 patients with confirmed APL either by t(15;17) or PML/RARA were treated according to the PETHEMA LPA 99 trial. Forty three patients achieved CR (86%). The remaining seven patients had early death (one died before treatment onset): four caused by differentiation syndrome (DS) and three died from central nervous system hemorrhage. Multivariate analysis revealed that female gender (P=0.045), baseline WBC> 10 G/L (P=0.041) and serum creatinine > 1.4mg/dl (P=0.021) were predictive of mortality during induction. DS was observed in 16 patients (32%) after a median onset time of 15 days from treatment onset (range, 2-29). Body mass index ≥ 30 (P=0.01) remained independent predictor of DS. Occurrence of hypertensive peaks significantly predicted occurrence of DS (P=0.011) and was significantly associated with high BMI (p=0.003). With a median follow-up of 50 months, 5 year cumulative incidence of relapse, event free and overall survival were 4.7%, 74% and 78%, respectively.
authors.affiliation: Hematology Department, Aziza Othmana University Hospital, Tunis, Tunisia.
authors.forename: Ramzi
authors.initials: R
authors.lastname: Jeddi
authors.forename: Hèla
authors.initials: H
authors.lastname: Ghédira
authors.forename: Ramzi
authors.initials: R
authors.lastname: Ben Amor
authors.forename: Yosr
authors.initials: Y
authors.lastname: Ben Abdennebi
authors.forename: Kacem
authors.initials: K
authors.lastname: Karima
authors.forename: Zarrouk
authors.initials: Z
authors.lastname: Mohamed
authors.forename: Hend
authors.initials: H
authors.lastname: Ben Neji
authors.forename: Lamia
authors.initials: L
authors.lastname: Aissaoui
authors.forename: Raihane
authors.initials: R
authors.lastname: Ben Lakhal
authors.forename: Naouel
authors.initials: N
authors.lastname: Ben Salah
authors.forename: Samia
authors.initials: S
authors.lastname: Menif
authors.forename: Zaher
authors.initials: Z
authors.lastname: Belhadjali
authors.forename: Hela
authors.initials: H
authors.lastname: Ben Abid
authors.forename: Emna
authors.initials: E
authors.lastname: Gouider
authors.forename: Raouf
authors.initials: R
authors.lastname: Hafsia
authors.forename: Ali
authors.initials: A
authors.lastname: Saad
authors.forename: Pierre
authors.initials: P
authors.lastname: Fenaux
authors.forename: Balkis
authors.initials: B
authors.lastname: Meddeb
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