Introducing biological features at diagnosis improves the relapse risk stratification in patients with acute promyelocytic leukemia treated with <scp>ATRA</scp> and chemotherapy

Breccia, Massimo; Propris, Maria Stefania De; Molica, Matteo; Colafigli, Gioia; Minotti, Clara; Diverio, Daniela; Latagliata, Roberto; Guarini, Anna; Foà, Robin

doi:10.1002/ajh.24033

Cited by 2 publications

(3 citation statements)

References 17 publications

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“…Previous studies on minimal residual disease (MRD)-related prognostic factors of survival and relapse were mostly in the context of ATRA chemotherapy and almost exclusively focussed on the time at which MRD became negative with prognosis. 20,22,27 This nearly 54-month long-term follow-up study further confirmed the high cure probability of ATRA plus oral arsenic as front-line therapy for non-high-risk APL. In addition, our present study showed that PML-RARA transcript levels of ≥6Á5% at the end of induction therapy were associated with relapse in the context of arsenic plus ATRA as front-line therapy for nonhigh-risk APL.…”

Section: Discussionsupporting

confidence: 62%

“…To our knowledge, the present study is the largest cohort study exploring arsenic plus ATRA as front‐line therapy for non‐high‐risk APL. Previous studies on minimal residual disease (MRD)‐related prognostic factors of survival and relapse were mostly in the context of ATRA chemotherapy and almost exclusively focussed on the time at which MRD became negative with prognosis 20,22,27 . This nearly 54‐month long‐term follow‐up study further confirmed the high cure probability of ATRA plus oral arsenic as front‐line therapy for non‐high‐risk APL.…”

Section: Discussionmentioning

confidence: 67%

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PML‐RARA transcript levels at the end of induction therapy are associated with prognosis in non‐high‐risk acute promyelocytic leukaemia with all‐trans retinoic acid plus arsenic in front‐line therapy: long‐term follow‐up of a single‐centre cohort study

Tang

Zhao

et al. 2021

Br J Haematol

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Summary Despite the high cure probability for acute promyelocytic leukaemia (APL), a minority of patients will relapse and the risk factors for relapse are unclear. We retrospectively analysed 212 patients who were diagnosed with non‐high‐risk APL and received all‐trans retinoic acid (ATRA) plus arsenic as front‐line therapy at Peking University Institute of Hematology from February 2014 to December 2018. A total of 176 patients (83%) received oral arsenic (realgar‐indigo naturalis formula) plus ATRA, 36 patients (17%) received arsenic trioxide plus ATRA and 203 patients were evaluable for relapse. After a median (range) follow‐up of 53·6 (24·3–85·4) months, two patients had molecular relapse and eight had haematological relapse. A promyelocytic leukaemia/retinoic acid receptor alpha (PML‐RARA) transcript level of ≥6·5% at the end of induction therapy was associated with relapse (P = 0·031). The 5‐year cumulative incidence of relapse, event‐free survival and overall survival were 5·5%, 92·3% and 96·3% respectively. In conclusion, the present long‐term follow‐up study further confirmed the high cure probability of ATRA plus oral arsenic as front‐line therapy for non‐high‐risk APL and showed that the PML‐RARA transcript level at the end of induction therapy was associated with relapse.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 67%

PML‐RARA transcript levels at the end of induction therapy are associated with prognosis in non‐high‐risk acute promyelocytic leukaemia with all‐trans retinoic acid plus arsenic in front‐line therapy: long‐term follow‐up of a single‐centre cohort study

Tang

Zhao

et al. 2021

Br J Haematol

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“…Patients with APL were further classified into low, intermediate, or high risk according to the Sanz score [15]. BMI was also compared to Breccia risk score, which predicts overall survival and disease‐free survival, by using the Sanz score as a base, with 0 points for low risk, 1 point for intermediate, and 2 points for high risk; transcript type, 0 for bcr1/2 and 1 for bcr3; FLT3 ‐ITD, 0 for absence and 1 for the presence; morphology, 0 for the classic form and 1 for the variant form; CD34 expression, 0 if absent and 1 if present [16]. Additional baseline characteristics compared with BMI were CD56 and CD15 expression at diagnosis, karyotype t(15;17) alone versus with additional abnormalities, central nervous system (CNS) involvement at diagnosis and relapse.…”

Section: Methodsmentioning

confidence: 99%

Increased body mass index is a risk factor for acute promyelocytic leukemia

Kashanian

Ali

et al. 2021

eJHaem

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Introduction Obesity has become increasingly prevalent worldwide and is a risk factor for many malignancies. We studied the correlation between body mass index (BMI) and the incidence of acute promyelocytic leukemia (APL), non‐APL acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and control hospitalized patients without leukemia in the same community. Methods Multicenter, retrospective analysis of 71 196 patients: APL (n = 200), AML (n = 437), ALL (n = 103), nonleukemia hospitalized (n = 70 456) admitted to University of Maryland and Johns Hopkins Cancer Centers, and University of Maryland Medical Center. Results Patients with APL had a significantly higher unadjusted mean and median BMI (32.5 and 30.3 kg/m2) than those with AML (28.3 and 27.1 kg/m2), ALL (29.3 and 27.7 kg/m2), and others (29.3 and 27.7 kg/m2) (P < .001). Log‐transformed BMI multivariable models demonstrated that APL patients had a significantly higher adjusted mean BMI by 3.7 kg/m2 (P < .001) or approximately 10% (P < .01) compared to the other groups, when controlled for sex, race, and age. Conclusions This study confirms that when controlled for sex, age, and race there is an independent association of higher BMI among patients with APL compared to patients with ALL, AML, and hospitalized individuals without leukemia in the same community.

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Introducing biological features at diagnosis improves the relapse risk stratification in patients with acute promyelocytic leukemia treated with ATRA and chemotherapy

Cited by 2 publications

References 17 publications

PML‐RARA transcript levels at the end of induction therapy are associated with prognosis in non‐high‐risk acute promyelocytic leukaemia with all‐trans retinoic acid plus arsenic in front‐line therapy: long‐term follow‐up of a single‐centre cohort study

PML‐RARA transcript levels at the end of induction therapy are associated with prognosis in non‐high‐risk acute promyelocytic leukaemia with all‐trans retinoic acid plus arsenic in front‐line therapy: long‐term follow‐up of a single‐centre cohort study

Increased body mass index is a risk factor for acute promyelocytic leukemia

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