All-trans retinoic acid significantly reduces the incidence of early hemorrhagic death during induction therapy of acute promyelocytic leukemia

Giuseppe Visani, Luigi Gugliotta, Patrizia Tosi, Lucia Catani, Nicola Vianelli, Giovanni Martinelli, Emanuela Ottaviani, Nicoletta Testoni, Franco Nocentini, Rocco Pastano, Pierpaolo Piccaluga, Alessandro Isidori, Tiziana Grafone, Sante Tura

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Early hemorrhagic death (within the first 10 d of treatment [EHD]) is reported as the main cause of death during induction therapy for acute promyelocytic leukemia (APL). In order to evaluate possible differences in the incidence of EHD during induction regimens based on all-trans retinoic acid (ATRA), we retrospectively analyzed a consecutive series of 86 APL patients, diagnosed and treated at our Institution from 1982. Forty-three patients received combination chemotherapy with anthracyclines and cytosine arabinoside (January 1982 to December 1991), while induction of the remaining 43 was based on ATRA alone or on a combination of ATRA and anthracyclines (January 1992 to October 1996). There were significantly less induction deaths in the ATRA group [9 (chemotherapy group-CT) vs. 2 (ATRA group-RA) overall and 8(CT) vs. 1(RA) of EHD; p=0.01]. Hemostatic evaluations showed an earlier reduction of D-dimer in the ATRA group. No cases of morphological resistance were observed in the ATRA group after induction. In addition, the number of relapses occurring in the first 24 months from the achievement of complete remission (CR) was significantly lower in the ATRA group (15 vs. 7; p=0.01), with a disease free survival at 2 yr of 67% vs. 31%. In conclusion, ATRA appears to be able to significantly reduce the incidence of EHD, increasing the number of possible long-term remissions.

Original languageEnglish
Pages (from-to)139-144
Number of pages6
JournalEuropean Journal of Haematology
Volume64
Issue number3
DOIs
Publication statusPublished - 2000

Fingerprint

Acute Promyelocytic Leukemia
Tretinoin
Incidence
Therapeutics
Anthracyclines
Cytarabine
Hemostatics
Combination Drug Therapy
Disease-Free Survival
Cause of Death
Recurrence
Drug Therapy

Keywords

  • Acute leukemia
  • All-trans retinoic acid
  • Early death
  • Hemorrhage
  • Promyelocytic

ASJC Scopus subject areas

  • Hematology

Cite this

All-trans retinoic acid significantly reduces the incidence of early hemorrhagic death during induction therapy of acute promyelocytic leukemia. / Visani, Giuseppe; Gugliotta, Luigi; Tosi, Patrizia; Catani, Lucia; Vianelli, Nicola; Martinelli, Giovanni; Ottaviani, Emanuela; Testoni, Nicoletta; Nocentini, Franco; Pastano, Rocco; Piccaluga, Pierpaolo; Isidori, Alessandro; Grafone, Tiziana; Tura, Sante.

In: European Journal of Haematology, Vol. 64, No. 3, 2000, p. 139-144.

Research output: Contribution to journalArticle

Visani, G, Gugliotta, L, Tosi, P, Catani, L, Vianelli, N, Martinelli, G, Ottaviani, E, Testoni, N, Nocentini, F, Pastano, R, Piccaluga, P, Isidori, A, Grafone, T & Tura, S 2000, 'All-trans retinoic acid significantly reduces the incidence of early hemorrhagic death during induction therapy of acute promyelocytic leukemia', European Journal of Haematology, vol. 64, no. 3, pp. 139-144. https://doi.org/10.1034/j.1600-0609.2000.09001.x
Visani, Giuseppe ; Gugliotta, Luigi ; Tosi, Patrizia ; Catani, Lucia ; Vianelli, Nicola ; Martinelli, Giovanni ; Ottaviani, Emanuela ; Testoni, Nicoletta ; Nocentini, Franco ; Pastano, Rocco ; Piccaluga, Pierpaolo ; Isidori, Alessandro ; Grafone, Tiziana ; Tura, Sante. / All-trans retinoic acid significantly reduces the incidence of early hemorrhagic death during induction therapy of acute promyelocytic leukemia. In: European Journal of Haematology. 2000 ; Vol. 64, No. 3. pp. 139-144.
@article{57893d952fbd4c308bb9c34778775943,
title = "All-trans retinoic acid significantly reduces the incidence of early hemorrhagic death during induction therapy of acute promyelocytic leukemia",
abstract = "Early hemorrhagic death (within the first 10 d of treatment [EHD]) is reported as the main cause of death during induction therapy for acute promyelocytic leukemia (APL). In order to evaluate possible differences in the incidence of EHD during induction regimens based on all-trans retinoic acid (ATRA), we retrospectively analyzed a consecutive series of 86 APL patients, diagnosed and treated at our Institution from 1982. Forty-three patients received combination chemotherapy with anthracyclines and cytosine arabinoside (January 1982 to December 1991), while induction of the remaining 43 was based on ATRA alone or on a combination of ATRA and anthracyclines (January 1992 to October 1996). There were significantly less induction deaths in the ATRA group [9 (chemotherapy group-CT) vs. 2 (ATRA group-RA) overall and 8(CT) vs. 1(RA) of EHD; p=0.01]. Hemostatic evaluations showed an earlier reduction of D-dimer in the ATRA group. No cases of morphological resistance were observed in the ATRA group after induction. In addition, the number of relapses occurring in the first 24 months from the achievement of complete remission (CR) was significantly lower in the ATRA group (15 vs. 7; p=0.01), with a disease free survival at 2 yr of 67{\%} vs. 31{\%}. In conclusion, ATRA appears to be able to significantly reduce the incidence of EHD, increasing the number of possible long-term remissions.",
keywords = "Acute leukemia, All-trans retinoic acid, Early death, Hemorrhage, Promyelocytic",
author = "Giuseppe Visani and Luigi Gugliotta and Patrizia Tosi and Lucia Catani and Nicola Vianelli and Giovanni Martinelli and Emanuela Ottaviani and Nicoletta Testoni and Franco Nocentini and Rocco Pastano and Pierpaolo Piccaluga and Alessandro Isidori and Tiziana Grafone and Sante Tura",
year = "2000",
doi = "10.1034/j.1600-0609.2000.09001.x",
language = "English",
volume = "64",
pages = "139--144",
journal = "European Journal of Haematology",
issn = "0902-4441",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "3",

}

TY - JOUR

T1 - All-trans retinoic acid significantly reduces the incidence of early hemorrhagic death during induction therapy of acute promyelocytic leukemia

AU - Visani, Giuseppe

AU - Gugliotta, Luigi

AU - Tosi, Patrizia

AU - Catani, Lucia

AU - Vianelli, Nicola

AU - Martinelli, Giovanni

AU - Ottaviani, Emanuela

AU - Testoni, Nicoletta

AU - Nocentini, Franco

AU - Pastano, Rocco

AU - Piccaluga, Pierpaolo

AU - Isidori, Alessandro

AU - Grafone, Tiziana

AU - Tura, Sante

PY - 2000

Y1 - 2000

N2 - Early hemorrhagic death (within the first 10 d of treatment [EHD]) is reported as the main cause of death during induction therapy for acute promyelocytic leukemia (APL). In order to evaluate possible differences in the incidence of EHD during induction regimens based on all-trans retinoic acid (ATRA), we retrospectively analyzed a consecutive series of 86 APL patients, diagnosed and treated at our Institution from 1982. Forty-three patients received combination chemotherapy with anthracyclines and cytosine arabinoside (January 1982 to December 1991), while induction of the remaining 43 was based on ATRA alone or on a combination of ATRA and anthracyclines (January 1992 to October 1996). There were significantly less induction deaths in the ATRA group [9 (chemotherapy group-CT) vs. 2 (ATRA group-RA) overall and 8(CT) vs. 1(RA) of EHD; p=0.01]. Hemostatic evaluations showed an earlier reduction of D-dimer in the ATRA group. No cases of morphological resistance were observed in the ATRA group after induction. In addition, the number of relapses occurring in the first 24 months from the achievement of complete remission (CR) was significantly lower in the ATRA group (15 vs. 7; p=0.01), with a disease free survival at 2 yr of 67% vs. 31%. In conclusion, ATRA appears to be able to significantly reduce the incidence of EHD, increasing the number of possible long-term remissions.

AB - Early hemorrhagic death (within the first 10 d of treatment [EHD]) is reported as the main cause of death during induction therapy for acute promyelocytic leukemia (APL). In order to evaluate possible differences in the incidence of EHD during induction regimens based on all-trans retinoic acid (ATRA), we retrospectively analyzed a consecutive series of 86 APL patients, diagnosed and treated at our Institution from 1982. Forty-three patients received combination chemotherapy with anthracyclines and cytosine arabinoside (January 1982 to December 1991), while induction of the remaining 43 was based on ATRA alone or on a combination of ATRA and anthracyclines (January 1992 to October 1996). There were significantly less induction deaths in the ATRA group [9 (chemotherapy group-CT) vs. 2 (ATRA group-RA) overall and 8(CT) vs. 1(RA) of EHD; p=0.01]. Hemostatic evaluations showed an earlier reduction of D-dimer in the ATRA group. No cases of morphological resistance were observed in the ATRA group after induction. In addition, the number of relapses occurring in the first 24 months from the achievement of complete remission (CR) was significantly lower in the ATRA group (15 vs. 7; p=0.01), with a disease free survival at 2 yr of 67% vs. 31%. In conclusion, ATRA appears to be able to significantly reduce the incidence of EHD, increasing the number of possible long-term remissions.

KW - Acute leukemia

KW - All-trans retinoic acid

KW - Early death

KW - Hemorrhage

KW - Promyelocytic

UR - http://www.scopus.com/inward/record.url?scp=0034071177&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034071177&partnerID=8YFLogxK

U2 - 10.1034/j.1600-0609.2000.09001.x

DO - 10.1034/j.1600-0609.2000.09001.x

M3 - Article

C2 - 10997878

AN - SCOPUS:0034071177

VL - 64

SP - 139

EP - 144

JO - European Journal of Haematology

JF - European Journal of Haematology

SN - 0902-4441

IS - 3

ER -