Haematologica (May 2021)
Characteristics and outcome of patients with low-/intermediate-risk acute promyelocytic leukemia treated with arsenic trioxide: an international collaborative study
- Sabine Kayser,
- Richard F. Schlenk,
- Delphine Lebon,
- Martin Carre,
- Katharina S. Götze,
- Friedrich Stölzel,
- Ana Berceanu,
- Kerstin Schäfer-Eckart,
- Pierre Peterlin,
- Yosr Hicheri,
- Ramy Rahme,
- Emmanuel Raffoux,
- Fatiha Chermat,
- Stefan W. Krause,
- Walter E. Aulitzky,
- Sophie Rigaudeau,
- Richard Noppeney,
- Celine Berthon,
- Martin Görner,
- Edgar Jost,
- Philippe Carassou,
- Ulrich Keller,
- Corentin Orvain,
- Thorsten Braun,
- Colombe Saillard,
- Ali Arar,
- Volker Kunzmann,
- Mathieu Wemeau,
- Maike de Wit,
- Dirk Niemann,
- Caroline Bonmati,
- Carsten Schwänen,
- Julie Abraham,
- Ahmad Aljijakli,
- Stephanie Haiat,
- Alwin Krämer,
- Albrecht Reichle,
- Martina Gnadler,
- Christophe Willekens,
- Karsten Spiekermann,
- Wolfgang Hiddemann,
- Carsten Müller-Tidow,
- Christian Thiede,
- Christoph Röllig,
- Hubert Serve,
- Martin Bornhäuser,
- Claudia D. Baldus,
- Eva Lengfelder,
- Pierre Fenaux,
- Uwe Platzbecker,
- Lionel Adès
Affiliations
- Sabine Kayser
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany; NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg
- Richard F. Schlenk
- NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg; Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg
- Delphine Lebon
- Service des Maladies du Sang GH Sud, Amiens
- Martin Carre
- 5HCE Grenoble, Service d'Oncologie et Hématologie Pédiatrique, Grenoble
- Katharina S. Götze
- Department of Medicine III, Technical University of Munich
- Friedrich Stölzel
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, TU Dresden
- Ana Berceanu
- Service d'Hématologie du Pr. Cahn Hopital Jean Minjoz, Besancon
- Kerstin Schäfer-Eckart
- Hospital Nord, Nurnberg
- Pierre Peterlin
- Service d'Hématologie, Hotel Dieu Nantes
- Yosr Hicheri
- Département d'Hématologie Clinique du Chu Saint Eloi Montpellier
- Ramy Rahme
- Hôpital Saint Louis, Université Paris Diderot, Paris
- Emmanuel Raffoux
- Hôpital Saint Louis, Université Paris Diderot, Paris
- Fatiha Chermat
- Hôpital Saint Louis, Université Paris Diderot, Paris
- Stefan W. Krause
- Department of Internal Medicine 5 – Hematology/Oncology, University Hospital of Erlangen
- Walter E. Aulitzky
- Robert-Bosch-Hospital, Stuttgart
- Sophie Rigaudeau
- Service d'Hémato-Oncologie du Pr. Castaigne Hopital Andre Mignot le Chesnay
- Richard Noppeney
- University Hospital Essen
- Celine Berthon
- Service des Maladies du Sang Chru, Hopital Claude Huriez, Lille
- Martin Görner
- Klinik für Hämatologie, Onkologie und Palliativmedizin, Klinikum Bielefeld Mitte
- Edgar Jost
- University Hospital Aachen
- Philippe Carassou
- Service de Médecine interne, Hématologie du Pr. Christian Chr Metz Thionville, Hopital de Marcy, Metz
- Ulrich Keller
- Department of Hematology, Oncology and Tumor Immunology, Charité-University Medical Center, Campus Benjamin Franklin, Berlin
- Corentin Orvain
- Angers University Hospital, Maladies du Sang, Angers; Fédération Hospitalo-Universitaire Grand-Ouest Acute Leukemia, FHU-GOAL, France; Université d'Angers, Inserm, CRCINA, Angers
- Thorsten Braun
- Hôpital Avicenne, Assistance Publique - Hôpitaux de Paris, Université Paris
- Colombe Saillard
- Hematology Department, Institut Paoli Calmettes, Marseille
- Ali Arar
- Service d' Oncologie Médicale Hopital de la Source, Orleans
- Volker Kunzmann
- University Hospital of Würzburg
- Mathieu Wemeau
- Service d'Hématologie, Hopital v.Provo, Roubaix
- Maike de Wit
- Vivantes Klinikum Neukölln, Berlin
- Dirk Niemann
- Gemeinschaftsklinikum Mittelrhein gGmbH, Koblenz
- Caroline Bonmati
- Division of Hematology, Hôpital de Brabois, Centre Hospitalier Universitaire de Nancy, Nancy
- Carsten Schwänen
- Klinikum Offenburg
- Julie Abraham
- Service d' Hématologie, Thérapie Cellulaire du Pr. Bordessoule, Hopital Universitaire Dupuytren, Limoges
- Ahmad Aljijakli
- Service d'Hématologie du Dr. Sutton Centre Hospitalier v. Dupouy, Argenteuil
- Stephanie Haiat
- Service d'Hematologie Clinique, CH Sud Francilien, Corbeil Essonnes
- Alwin Krämer
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg; German Cancer Research Center (DKFZ) and Department of Internal Medicine V, University of Heidelberg, Heidelberg
- Albrecht Reichle
- Department of Medicine III - Hematology and Internal Oncology, University Hospital Regensburg, Regensburg
- Martina Gnadler
- St. Vincentius Kliniken, Abteilung für Hämatologie, Onkologie, Immunologie und Palliativmedizin, Karlsruhe
- Christophe Willekens
- Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, Villejuif; INSERM Unit 1170, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif
- Karsten Spiekermann
- Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich
- Wolfgang Hiddemann
- Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich
- Carsten Müller-Tidow
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg
- Christian Thiede
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, TU Dresden
- Christoph Röllig
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, TU Dresden
- Hubert Serve
- Department of Internal Medicine II, University Hospital of Frankfurt Main
- Martin Bornhäuser
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, TU Dresden
- Claudia D. Baldus
- Department of Internal Medicine II, University Hospital of Kiel
- Eva Lengfelder
- Department of Hematology and Oncology, University Hospital Mannheim, Mannheim
- Pierre Fenaux
- Hôpital Saint Louis, Université Paris Diderot, Paris
- Uwe Platzbecker
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig
- Lionel Adès
- Hôpital Saint Louis, Université Paris Diderot, Paris
- DOI
- https://doi.org/10.3324/haematol.2021.278722
- Journal volume & issue
-
Vol. 106,
no. 12
Abstract
The aim of this study was to characterize a large series of 154 patients with acute promyelocytic leukemia (median age, 53 years; range, 18-90 years) and evaluate real-life outcome after up-front treatment with arsenic trioxide and all-trans retinoic acid. All patients were included in the prospective NAPOLEON registry (NCT02192619) between 2013 and 2019. The acute promyelocytic leukemia was de novo in 91% (n=140) and therapy-related in 9% (n=14); 13% (n=20) of the patients were older than 70 years. At diagnosis bleeding/hemorrhage was present in 38% and thrombosis in 3%. Complete remission was achieved in 152 patients (99%), whereas two patients (1%) experienced induction death within 18 days after starting therapy. With a median follow-up of 1.99 years (95% confidence interval: 1.61-2.30 years) 1-year and 2-year overall survival rates were 97% (95% confidence interval: 94-100%) and 95% (95% confidence interval: 91-99%), respectively. Age above 70 years was associated with a significantly shorter overall survival (P<0.001) compared to that of younger patients. So far no relapses have been observed. Six patients (4%) died in complete remission at a median of 0.95 years after diagnosis (range, 0.18-2.38 years). Our data confirm the efficiency and durability of arsenic trioxide and all-trans retinoic acid therapy in the primary management of adults with low-/intermediate-risk acute promyelocytic leukemia in the real-life setting, irrespective of age.
