Lengfelder, Eva, Goerlich, Dennis, Nowak, Daniel, Spiekermann, Karsten, Haferlach, Claudia, Krug, Utz, Kreuzer, Karl-Anton, Braess, Jan, Schliemann, Christoph, Lindemann, Hans-Walter, Horst, Heinz A., Schiel, Xaver, Flasshove, Michael, Hecht, Anna, Schnittger, Susanne, Schneider, Stephanie, Woermann, Bernhard, Hofmann, Wolf-Karsten, Berdel, Wolfgang E., Bormann, Eike, Sauerland, Cristina, Buechner, Thomas and Hiddemann, Wolfgang (2018). Frontline therapy of acute promyelocytic leukemia: Randomized comparison of ATRA and intensified chemotherapy versus ATRA and anthracyclines. Eur. J. Haematol., 100 (2). S. 154 - 163. HOBOKEN: WILEY. ISSN 1600-0609

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Abstract

Objectives: Randomized comparison of two treatment strategies in frontline therapy of acute promyelocytic leukemia (APL): all-trans retinoic acid (ATRA) and double induction intensified by high-dose cytosine arabinoside (HD ara-C) (German AMLCG) and therapy with ATRA and anthracyclines (Spanish PETHEMA, LPA99). Patients and results: Eighty of 87 adult patients with genetically confirmed APL of all risk groups were eligible. The outcome of both arms was similar: AMLCG vs PETHEMA: hematological complete remission 87% vs 83%, early death 13% vs 17% (P = .76), overall survival, event-free survival, leukemia-free survival, cumulative incidence of relapse at 6 years 75% vs 78% (P = .92); 75% vs 68% (P = .29); 86% vs 81% (P = .28); and 0% vs 12% (P = .04, no relapse vs four relapses), respectively. The median time to achieve molecular remission (RT-PCR negativity of PML-RARA) was 60 days in both arms (P = .12). The AMLCG regimen was associated with a longer duration of neutropenia (P = .02) and a higher rate of WHO grade >= 3 infections. Conclusions: The small number of patients limits the reliability of conclusions. With these restrictions, the outcomes of both approaches were similar and show the limitations of ATRA and chemotherapy. The HD ara-C-containing regimen was associated with a lower relapse rate in high-risk APL.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Lengfelder, EvaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goerlich, DennisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nowak, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spiekermann, KarstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haferlach, ClaudiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krug, UtzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kreuzer, Karl-AntonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Braess, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schliemann, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lindemann, Hans-WalterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Horst, Heinz A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schiel, XaverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Flasshove, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hecht, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schnittger, SusanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schneider, StephanieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Woermann, BernhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hofmann, Wolf-KarstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berdel, Wolfgang E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bormann, EikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sauerland, CristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buechner, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hiddemann, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-197230
DOI: 10.1111/ejh.12994
Journal or Publication Title: Eur. J. Haematol.
Volume: 100
Number: 2
Page Range: S. 154 - 163
Date: 2018
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1600-0609
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
TRANS-RETINOIC ACID; RISK-ADAPTED TREATMENT; ACUTE MYELOID-LEUKEMIA; FUSION GENE TRANSCRIPTS; ARSENIC TRIOXIDE; RESIDUAL-DISEASE; PETHEMA GROUP; TRIAL; CYTARABINE; MONOCHEMOTHERAPYMultiple languages
HematologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/19723

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