title: Survival and treatment response in adults with acute promyelocytic leukemia treated with a modified International Consortium on Acute Promyelocytic Leukemia protocol.
abstract: Acute promyelocytic leukemia has good prognosis in view of the high complete remission and survival rates achieved with therapies containing all-trans retinoic acid or arsenic trioxide. However, there is a significant risk of death during induction due to hemorrhage secondary to disseminated intravascular coagulation. This has contributed to a gap in the prognosis of patients between developed and developing countries. The International Consortium on Acute Promyelocytic Leukemia was created in 2005 and proposed a treatment protocol based on daunorubicin and all-trans retinoic acid stratified by risk geared toward developing countries. Herein are presented the results from the first patient cohort treated in a single developing country hospital employing a slightly modified version of the International Consortium protocol in a real life setting. Twenty patients with acute promyelocytic leukemia were enrolled: 27.8% had low-risk, 55.6% intermediate risk and 16.7% high-risk. The complete remission rate was 94.4% after a median of 42 days. Both relapse rates and death rates were one patient (5.5%) each. No deaths were observed during consolidation. After a median follow-up of 29 months, the overall survival rate was 89.1%. Efficacy and safety of the International Consortium on Acute Promyelocytic Leukemia protocol has been reproduced in acute promyelocytic leukemia patients from a developing country.
authors.affiliation: Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México, Mexico. Electronic address: erick.crespo.solis@gmail.com.
authors.forename: Erick
authors.initials: E
authors.lastname: Crespo-Solis
authors.affiliation: Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México, Mexico.
authors.forename: Jorge
authors.initials: J
authors.lastname: Contreras-Cisneros
authors.affiliation: Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México, Mexico.
authors.forename: Roberta
authors.initials: R
authors.lastname: Demichelis-Gómez
authors.affiliation: Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México, Mexico.
authors.forename: Adriana
authors.initials: A
authors.lastname: Rosas-López
authors.affiliation: Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México, Mexico.
authors.forename: Juan Mauricio
authors.initials: JM
authors.lastname: Vera-Zertuche
authors.affiliation: Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México, Mexico.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Aguayo
authors.affiliation: Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México, Mexico.
authors.forename: Xavier
authors.initials: X
authors.lastname: López-Karpovitch
keywords: Acute promyelocytic leukemia; Developing countries; IC-APL protocol; Survival