Autologous transplant remains the preferred therapy for relapsed APL in CR2. Bone Marrow Transplant 2016 Sep;51(9):1180-3
Date
04/19/2016Pubmed ID
27088379Pubmed Central ID
PMC5014591DOI
10.1038/bmt.2016.96Scopus ID
2-s2.0-84964375886 (requires institutional sign-in at Scopus site) 32 CitationsAbstract
Despite their favorable prognosis, 10-20% of acute promyelocytic leukemia (APL) patients relapse. Reinduction therapy is often followed by autologous hematopoietic cell transplantation (auto-HCT). Arsenic trioxide (ATO) has become part of standard reinduction and is often followed by auto-HCT. Data on patients in CR2 were collected from two large transplant registries (Center for International Blood and Marrow Transplant Research (CIBMTR) and European Group for Blood and Marrow Transplant (EBMT)) and two specialty referral centers. The outcome of patients in CR2 who received only ATO-based therapy as reinduction was retrospectively compared with those who got an auto-HCT, with or without ATO. Prognostic factors included age, disease risk, extramedullary disease and duration of CR1. Of 207 evaluable patients, the median age was 31.5 years, 15.3% had extramedullary disease and median WBC at diagnosis was 4.8 × 10(9)/L. Sixty-seven patients received ATO alone and 140 underwent auto-HCT. The groups were comparable for age, gender, extramedullary disease, risk group and duration of CR1. At 5 years, overall survival (OS) was 42% and 78% for the ATO-only and auto-HCT groups, respectively (P<0.001). In addition, OS was associated with longer duration of CR1 (P=0.002), but not with disease risk at diagnosis. These data suggest that auto-HCT for APL patients in CR2 results in better OS than ATO-based therapy alone.
Author List
Ganzel C, Mathews V, Alimoghaddam K, Ghavamzadeh A, Kuk D, Devlin S, Wang H, Zhang MJ, Weisdorf D, Douer D, Rowe JM, Polge E, Esteve J, Nagler A, Mohty M, Tallman MSAuthor
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Arsenicals
Child
Child, Preschool
Combined Modality Therapy
Female
Hematopoietic Stem Cell Transplantation
Humans
Induction Chemotherapy
Infant
Leukemia, Promyelocytic, Acute
Male
Middle Aged
Oxides
Recurrence
Remission Induction
Retrospective Studies
Survival Analysis
Transplantation, Autologous
Treatment Outcome
Young Adult
