title: Arsenic trioxide-based therapy of relapsed acute promyelocytic leukemia: registry results from the European LeukemiaNet.
abstract: In 2008, a European registry of relapsed acute promyelocytic leukemia was established by the European LeukemiaNet. Outcome data were available for 155 patients treated with arsenic trioxide in first relapse. In hematological relapse (n=104), 91% of the patients entered complete hematological remission (CR), 7% had induction death and 2% resistance, 27% developed differentiation syndrome and 39% leukocytosis, whereas no death or side effects occurred in patients treated in molecular relapse (n=40). The rate of molecular (m)CR was 74% in hematological and 62% in molecular relapse (P=0.3). All patients with extramedullary relapse (n=11) entered clinical and mCR. After 3.2 years median follow-up, the 3-year overall survival (OS) and cumulative incidence of second relapse were 68% and 41% in hematological relapse, 66% and 48% in molecular relapse and 90 and 11% in extramedullary relapse, respectively. After allogeneic or autologous transplantation in second CR (n=93), the 3-year OS was 80% compared with 59% without transplantation (n=55) (P=0.03). Multivariable analysis demonstrated the favorable prognostic impact of first remission duration ⩾1.5 years, achievement of mCR and allogeneic or autologous transplantation on OS of patients alive after induction (P=0.03, P=0.01, P=0.01) and on leukemia-free survival (P=0.006, P<0.0001, P=0.003), respectively.
authors: Department of Hematology and Oncology, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany.
authors: E
authors: E
authors: Lengfelder
authors: Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy.
authors: F
authors: F
authors: Lo-Coco
authors: Hopital St Louis, Paris, France.
authors: L
authors: L
authors: Ades
authors: Department of Hematology, University Hospital La Fe and Department of Medicine, University of Valencia, Valencia, Spain.
authors: P
authors: 0000000232755593
authors: P
authors: Montesinos
authors: Department of Medical and Molecular Genetics, King's College London London, UK.
authors: D
authors: D
authors: Grimwade
authors: Heartofengland NHS Foundation Trust, Birmingham, UK.
authors: B
authors: B
authors: Kishore
authors: Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy.
authors: S M
authors: SM
authors: Ramadan
authors: Evangelismos Hospital, Athens, Greece.
authors: M
authors: M
authors: Pagoni
authors: Department of Cellular Biotechnology and Hematology, Sapienza University, Rome, Italy.
authors: M
authors: M
authors: Breccia
authors: Hospital General de Alicante, Alicante, Spain.
authors: A J G
authors: AJ
authors: Huerta
authors: Hopital St Louis, Paris, France.
authors: A M
authors: AM
authors: Nloga
authors: Hospital Insular de Las Palmas, Las Palmas, Spain.
authors: J D
authors: JD
authors: González-Sanmiguel
authors: Department of Hematology and Oncology, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany.
authors: A
authors: A
authors: Schmidt
authors: Service d'Hématologie du CHUV, Lausanne, Switzerland.
authors: J-F
authors: JF
authors: Lambert
authors: Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.
authors: S
authors: S
authors: Lehmann
authors: San Bortolo Hospital, Vicenza, Italy.
authors: E
authors: E
authors: Di Bona
authors: Hopital St Louis, Paris, France.
authors: B
authors: B
authors: Cassinat
authors: Department of Hematology and Oncology, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany.
authors: W-K
authors: WK
authors: Hofmann
authors: Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany.
authors: D
authors: D
authors: Görlich
authors: Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany.
authors: M-C
authors: MC
authors: Sauerland
authors: Hopital St Louis, Paris, France.
authors: P
authors: P
authors: Fenaux
authors: Department of Hematology, University Hospital La Fe and Department of Medicine, University of Valencia, Valencia, Spain.
authors: M
authors: M
authors: Sanz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000627:therapeutic use*; D002454:Cell Differentiation; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005060:Europe; D005260:Female; D006801:Humans; D007391:International Cooperation; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010087:Oxides / Q000627:therapeutic use*; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001152:Arsenicals; D010087:Oxides; D000077237:Arsenic Trioxide
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