title: Prognostic factors of patients with newly diagnosed acute promyelocytic leukemia treated with arsenic trioxide-based frontline therapy.
abstract: Prognostic factors for patients with acute promyelocytic leukemia (APL) treated in the context of arsenic trioxide (ATO)-based frontline regimes have not been established clearly. We retrospectively analyzed the clinical features, immunophenotypes, Fms-like tyrosine kinase-3 internal tandem duplication (FLT3-ITD), and outcomes of 184 consecutive newly diagnosed APL patients treated by intravenous ATO-based therapy. The median age was 40 years (14-77 years). The early death rate was 4.9% (9/184 patients). With a median follow-up time of 36 months (9-74 months), the 3-year relapse-free survival (RFS) and overall survival (OS) were 93.3% and 92.2%, respectively. Interestingly, there was no meaningful association between 3-year RFS and initial white blood cell count, FLT3-ITD status, or type of PML-RARA isoforms. In multivariable analysis, the CD56 expression was the only independent risk factor in terms of RFS (hazard ratio, 4.70; P=0.005). These results suggested that ATO-based therapy may ameliorate the unfavorable influence of previously known high-risk features; moreover, CD56 expression remains to be a potentially unfavorable prognostic factor in APL patients.
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Yinjun
authors.initials: Y
authors.lastname: Lou
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Yafang
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Suo
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Wanmao
authors.initials: W
authors.lastname: Ni
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Yungui
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Hanzhang
authors.initials: H
authors.lastname: Pan
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Tong
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Qian
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Meng
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Wenyuan
authors.initials: W
authors.lastname: Mai
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Wenjuan
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Juyin
authors.initials: J
authors.lastname: Wei
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Mao
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, China. Electronic address: zjuhematology@163.com.
authors.forename: Jie
authors.initials: J
authors.lastname: Jin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000235:genetics*; D019002:CD56 Antigen / Q000235:genetics*; D058674:Chromosome Duplication; D005260:Female; D015870:Gene Expression; D006801:Humans; D007275:Injections, Intravenous; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015514:Oncogene Proteins, Fusion / Q000235:genetics*; D010087:Oxides / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D051941:fms-Like Tyrosine Kinase 3 / Q000235:genetics*
chemical_list: D001152:Arsenicals; D014408:Biomarkers, Tumor; D019002:CD56 Antigen; C522918:NCAM1 protein, human; D015514:Oncogene Proteins, Fusion; D010087:Oxides; C093476:promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein; C497970:FLT3 protein, human; D051941:fms-Like Tyrosine Kinase 3; D000077237:Arsenic Trioxide
keywords: Acute promyelocytic leukemia; Arsenic trioxide; CD56 expression; FLT3 mutation; Prognostic factors