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Acute Leukemias

Arsenic trioxide-based therapy of relapsed acute promyelocytic leukemia: registry results from the European LeukemiaNet

Leukemia volume 29, pages 1084–1091 (2015)Cite this article

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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.

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Acknowledgements

The online registry for data collection was supported by the companies CEPHALON and TEVA.

Author information

Authors and Affiliations

  1. Department of Hematology and Oncology, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany

    E Lengfelder, A Schmidt & W-K Hofmann

  2. Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy

    F Lo-Coco & S M Ramadan

  3. Hopital St Louis, Paris, France

    L Ades, A M Nloga, B Cassinat & P Fenaux

  4. Department of Hematology, University Hospital La Fe and Department of Medicine, University of Valencia, Valencia, Spain

    P Montesinos & M Sanz

  5. Department of Medical and Molecular Genetics, King’s College London, London, UK

    D Grimwade

  6. Heartofengland NHS Foundation Trust, Birmingham, UK

    B Kishore

  7. Evangelismos Hospital, Athens, Greece

    M Pagoni

  8. Department of Cellular Biotechnology and Hematology, Sapienza University, Rome, Italy

    M Breccia

  9. Hospital General de Alicante, Alicante, Spain

    A J G Huerta

  10. Hospital Insular de Las Palmas, Las Palmas, Spain

    J D González-Sanmiguel

  11. Service d’Hématologie du CHUV, Lausanne, Switzerland

    J-F Lambert

  12. Department of Hematology, Karolinska University Hospital, Stockholm, Sweden

    S Lehmann

  13. San Bortolo Hospital, Vicenza, Italy

    E Di Bona

  14. Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany

    D Görlich & M-C Sauerland

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  1. E Lengfelder
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  9. M Breccia
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  22. M Sanz
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Correspondence to E Lengfelder.

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Competing interests

Eva Lengfelder and David Grimwade received research support from CEPHALON and TEVA. Francesco Lo-Coco and Maria Pagoni participated in speaker’s bureau of TEVA. The other authors declare no conflict of interest.

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Lengfelder, E., Lo-Coco, F., Ades, L. et al. Arsenic trioxide-based therapy of relapsed acute promyelocytic leukemia: registry results from the European LeukemiaNet. Leukemia 29, 1084–1091 (2015). https://doi.org/10.1038/leu.2015.12

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