TREATMENT OF ACUTE PROMYELOCYTIC LEUKEMIA WITH AIDA BASED REGIMEN

Abstract

<p class="MsoNormal" style="text-align: justify; line-height: 200%; margin: 0cm 0cm 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><span lang="EN-GB" style="mso-ansi-language: EN-GB;">In Tunisia, the ATRA era began in 1998 with the use, consecutively, of two regimens combining ATRA and an anthracycline with cytarabine (APL93), and without cytarabine (LPA99). From 2004, 51 patients with confirmed APL either by t(15;17) or PML/RARA were treated according to the PETHEMA LPA 99 trial. Forty three patients achieved CR (86%). The remaining seven patients had early death (one died before treatment onset): four caused by differentiation syndrome (DS) and three died from central nervous system hemorrhage.</span><span lang="EN-GB" style="font-family: AdvP497E2; mso-bidi-font-family: AdvP497E2; mso-ansi-language: EN-GB;"> Multivariate analysis revealed that female gender (P=0.045), baseline WBC&gt; 10 G/L ( </span><span lang="EN-GB" style="font-family: AdvP497E3; mso-bidi-font-family: AdvP497E3; mso-ansi-language: EN-GB;">P=0.041</span><span lang="EN-GB" style="font-family: AdvP497E2; mso-bidi-font-family: AdvP497E2; mso-ansi-language: EN-GB;">) and serum creatinine &gt; 1.4mg/dl ( P=0.021) were predictive of mortality during induction. </span><span lang="EN-GB" style="mso-ansi-language: EN-GB;"><span style="mso-spacerun: yes;"> </span>DS was observed in 16 patients (32%) after a median onset time of 15 days from treatment onset (range, 2–29). Body mass index ≥ 30 (P=0.01) was the only independent predictor of DS. Occurrence of hypertensive peaks significantly predicted occurrence of DS (P=0.011) and was significantly associated with high BMI (p=0.003). With a median follow-up of<span style="mso-spacerun: yes;"> </span>50 months, 5 year cumulative incidence of relapse, event free and overall survival were 4.7%, 74% and 78%, respectively.</span></span></span></p>

Keywords

• Leukemia