Allogeneic stem cell transplantation for advanced acute promyelocytic leukemia in the ATRA and ATO era.
The role of allogeneic stem cell transplant in advanced acute promyelocytic leukemia patients who received standard first- and second-line therapy is still unknown. We report the outcome of 31 acute promyelocytic leukemia patients (median age 39 years) who underwent allogeneic transplant in second remission (n=15) or beyond (n=16). Sixteen patients were real-time polymerase chain reaction positive and 15 negative for PML/RARA pre-transplant. The 4-year overall survival was 62% and 31% for patients transplanted in second remission and beyond, respectively (P=0.05), and 64% and 27% for patients with pre-transplant negative and positive real-time polymerase chain reaction, respectively (P=0.03). The 4-year cumulative incidence of relapse was 32% and 44% for patients transplanted in second remission and beyond, respectively (P=0.37), and 30% and 47% for patients transplanted with negative and positive real-time polymerase chain reaction, respectively (P=0.30). Transplant-related mortality was 19.6%. In conclusion, allogeneic transplant is effective in advanced acute promyelocytic leukemia in the all-trans-retinoic acid and arsenic trioxide era, and should be considered once relapse is diagnosed.
Department of Biopathology, University of Rome Tor Vergata, Italy. safaanci@yahoo.com
Safaa M
SM
Ramadan
Ambra
A
Di Veroli
Agnese
A
Camboni
Massimo
M
Breccia
Anna Paola
AP
Iori
Franco
F
Aversa
Luca
L
Cupelli
Cristina
C
Papayannidis
Andrea
A
Bacigalupo
William
W
Arcese
Francesco
F
Lo-Coco
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000235:genetics / Q000378:metabolism / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015514:Oncogene Proteins, Fusion / Q000235:genetics / Q000378:metabolism; D010087:Oxides / Q000008:administration & dosage*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014184:Transplantation, Homologous; D014212:Tretinoin / Q000008:administration & dosage*
D000970:Antineoplastic Agents; D001152:Arsenicals; D015514:Oncogene Proteins, Fusion; D010087:Oxides; C093476:promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein; D014212:Tretinoin; D000077237:Arsenic Trioxide