title: Delay in the administration of all-trans retinoic acid and its effects on early mortality in acute promyelocytic leukemia: final results of a multicentric study in the United States.
abstract: Early death (ED) occurs in 10-30% of patients with acute promyelocytic leukemia (APL). Is all-trans retinoic acid (ATRA) promptly given and does it decrease overall early mortality? ATRA was administered within 24h of morphological suspicion in only 44% of the 120 consecutive patients treated in the four collaborating centers. Absence of disseminated intravascular coagulation (p=0.012) and admission to a non-university-affiliated hospital (p=0.032) were independent predictors of ATRA delay. ED occurred in 17% of patients, and was independently correlated only with ICU admission (p=0.002). Our results do not demonstrate that prompt (versus delayed) ATRA administration decreases overall early death.
authors.affiliation: Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA, United States. Electronic address: arashidi@dom.wustl.edu.
authors.forename: Armin
authors.initials: A
authors.lastname: Rashidi
authors.affiliation: Department of Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA, United States.
authors.forename: Meghan
authors.initials: M
authors.lastname: Riley
authors.affiliation: Department of Pathology, University of Virginia, Charlottesville, VA, United States.
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Goldin
authors.affiliation: Department of Pathology, West Virginia University, Morgantown, WV, United States.
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Sayedian
authors.affiliation: Department of Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA, United States.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Bayerl
authors.affiliation: Department of Pathology, University of Virginia, Charlottesville, VA, United States.
authors.forename: Nadine S
authors.initials: NS
authors.lastname: Aguilera
authors.affiliation: Department of Pathology, West Virginia University, Morgantown, WV, United States.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Vos
authors.affiliation: Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA, United States; Virginia Oncology Associates, Norfolk, VA, United States.
authors.forename: Ranjit K
authors.initials: RK
authors.lastname: Goudar
authors.affiliation: Pathology Sciences Medical Group/Sentara Laboratory Services, Norfolk, VA, United States.
authors.forename: Stephen I
authors.initials: SI
authors.lastname: Fisher
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D004211:Disseminated Intravascular Coagulation / Q000401:mortality; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000706:statistics & numerical data; D016019:Survival Analysis; D061665:Time-to-Treatment; D014212:Tretinoin / Q000008:administration & dosage*; D014481:United States / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents; D014212:Tretinoin
keywords: ATRA; Death; Leukemia; Promyelocytic