All-trans retinoic acid with daunorubicin or idarubicin for risk-adapted treatment of acute promyelocytic leukaemia: a matched-pair analysis of the PETHEMA LPA-2005 and IC-APL studies

Miguel A. Sanz, Pau Montesinos, Haesook T. Kim, Guillermo J. Ruiz-Argüelles, María S. Undurraga, María R. Uriarte, Lem Martínez, Rafael H. Jacomo, Homero Gutiérrez-Aguirre, Raul A M Melo, Rosane Bittencourt, Ricardo Pasquini, Katia Pagnano, Evandro M. Fagundes, Edo Vellenga, Alexandra Holowiecka, Ana J. González-Huerta, Pascual Fernández, Javier de la Serna, Salut BrunetElena de Lisa, José González-Campos, José M. Ribera, Isabel Krsnik, Arnold Ganser, Nancy Berliner, Raul C. Ribeiro, Francesco Lo-Coco, Bob Löwenberg, Eduardo M. Rego, Behalf Of The Ic-Apl On Behalf Of The Ic-Apl

Research output: Contribution to journalArticlepeer-review

Abstract

Front-line treatment of acute promyelocytic leukaemia (APL) consists of all-trans retinoic acid (ATRA) and anthracycline-based chemotherapy. In this setting, a comparison of idarubicin and daunorubicin has never been carried out. Two similar clinical trials using ATRA and chemotherapy for newly diagnosed APL were compared using matched-pair analysis. One was conducted by the PETHEMA/HOVON group with idarubicin and the other by the International Consortium on APL (IC-APL) using daunorubicin. Three hundred and fifty patients from the PETHEMA/HOVON cohort were matched with 175 patients in the IC-APL cohort, adjusting for the significantly unbalanced presenting features of the two entire cohorts. Complete remission (CR) rate was significantly higher in the PETHEMA/HOVON (94 %) than in the IC-APL cohort (85 %) (P = 0.002). The distribution of causes of induction failure and the time to achieve CR were similar in both cohorts. Patients who achieved CR had comparable cumulative incidence of relapse and disease-free survival rates, but lower overall and event-free survivals were observed in the IC-APL cohort, which was mainly due to a higher death rate during induction therapy. A higher death rate during consolidation therapy was also observed in the IC-APL. These results show that daunorubicin and idarubicin have similar antileukaemic efficacy in terms of primary resistance, molecular persistence, as well as molecular and haematological relapse rates when combined with ATRA in treatment of APL. However, a higher toxic death rate during induction and consolidation therapy was observed in the IC-APL cohort. This trial was registered at www.clinicaltrials.govas #NCT00408278 [ClinicalTrials.gov].

Original languageEnglish
JournalAnnals of Hematology
Volume94
Issue number8
DOIs
Publication statusPublished - May 15 2015

Keywords

  • Acute promyelocytic leukaemia
  • All-trans retinoic acid
  • Anthracyclines
  • Cytarabine
  • Matched-pair analysis
  • Prognostic factors
  • Risk-adapted therapy

ASJC Scopus subject areas

  • Medicine(all)
  • Hematology

Fingerprint

Dive into the research topics of 'All-trans retinoic acid with daunorubicin or idarubicin for risk-adapted treatment of acute promyelocytic leukaemia: a matched-pair analysis of the PETHEMA LPA-2005 and IC-APL studies'. Together they form a unique fingerprint.

Cite this