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- Title
High dose ara-C in the treatment of newly diagnosed acute promyelocytic leukemia: long-term results of the German AMLCG.
- Authors
Lengfelder, E.; Haferlach, C.; Saussele, S.; Haferlach, T.; Schultheis, B.; Schnittger, S.; Ludwig, W.-D.; Staib, P.; Aul, C.; Grüneisen, A.; Kern, W.; Reichle, A.; Serve, H.; Berdel, W. E.; Braess, J.; Spiekermann, K.; Wörmann, B.; Sauerland, M.-C.; Heinecke, A.; Hiddemann, W.
- Abstract
The objective of this study for newly diagnosed acute promyelocytic Leukemia (APL) was to evaluate the efficacy of an intensified double induction chemotherapy including high dose ara-C (HD) and all-trans retinoic acid (ATRA) followed by consolidation and 3 years maintenance therapy. In contrast to APL studies stratifying therapy according to pretreatment white blood cell (WBC) count < and 10 × 109/l (low/intermediate and high risk according to the Sanz score), our patients received uniform therapy. From 1994 to 2005, 142 patients (age, 16–60 years) were enrolled. In the low/intermediate (n=105) vs high (n=37) WBC group, the rates of complete remission were 95.2 vs 83.8%, of induction death were 4.8 vs 16.2% (P=0.05) and of molecular remission were 87.5 vs 91.3% (P=1). Long-term overall survival was 84.4 vs 73.0% (P=0.12), event free survival was 78.3 vs 67.3% (P=0.11), relapse free survival was 82.1 vs 80.0% (P=0.83) and the cumulative incidence of relapse was 7.4 vs 11.4% (P=0.46). No relapse or death occurred after 4.7 years. ATRA and intensified chemotherapy including HD ara-C followed by prolonged maintenance therapy reduced the relapse risk in high risk patients. Pretreatment WBC count 10 × 109/l count was no relevant prognostic factor for relapse.
- Subjects
LEUKEMIA; DRUG therapy; TRETINOIN; LEUCOCYTES; LEUCOCYTOSIS
- Publication
Leukemia (08876924), 2009, Vol 23, Issue 12, p2248
- ISSN
0887-6924
- Publication type
Article
- DOI
10.1038/leu.2009.183