TY - JOUR
T1 - Allogeneic stem cell transplantation for advanced acute promyelocytic leukemia in the ATRA and ATO era
AU - Ramadan, Safaa M.
AU - Veroli, Ambra Di
AU - Camboni, Agnese
AU - Breccia, Massimo
AU - Iori, Anna Paola
AU - Aversa, Franco
AU - Cupelli, Luca
AU - Papayannidis, Cristina
AU - Bacigalupo, Andrea
AU - Arcese, William
AU - Lo-Coco, Francesco
PY - 2012/11/1
Y1 - 2012/11/1
N2 - The role of allogeneic stem cell transplant in advanced acute promyelocytic leukemia patients who received standard first- and second-line therapy is still unknown. We report the outcome of 31 acute promyelocytic leukemia patients (median age 39 years) who underwent allogeneic transplant in second remission (n=15) or beyond (n=16). Sixteen patients were real-time polymerase chain reaction positive and 15 negative for PML/RARA pre-transplant. The 4-year overall survival was 62% and 31% for patients transplanted in second remission and beyond, respectively (P=0.05), and 64% and 27% for patients with pre-transplant negative and positive real-time polymerase chain reaction, respectively (P=0.03). The 4-year cumulative incidence of relapse was 32% and 44% for patients transplanted in second remission and beyond, respectively (P=0.37), and 30% and 47% for patients transplanted with negative and positive real-time polymerase chain reaction, respectively (P=0.30). Transplantrelated mortality was 19.6%. In conclusion, allogeneic transplant is effective in advanced acute promyelocytic leukemia in the all-trans-retinoic acid and arsenic trioxide era, and should be considered once relapse is diagnosed.
AB - The role of allogeneic stem cell transplant in advanced acute promyelocytic leukemia patients who received standard first- and second-line therapy is still unknown. We report the outcome of 31 acute promyelocytic leukemia patients (median age 39 years) who underwent allogeneic transplant in second remission (n=15) or beyond (n=16). Sixteen patients were real-time polymerase chain reaction positive and 15 negative for PML/RARA pre-transplant. The 4-year overall survival was 62% and 31% for patients transplanted in second remission and beyond, respectively (P=0.05), and 64% and 27% for patients with pre-transplant negative and positive real-time polymerase chain reaction, respectively (P=0.03). The 4-year cumulative incidence of relapse was 32% and 44% for patients transplanted in second remission and beyond, respectively (P=0.37), and 30% and 47% for patients transplanted with negative and positive real-time polymerase chain reaction, respectively (P=0.30). Transplantrelated mortality was 19.6%. In conclusion, allogeneic transplant is effective in advanced acute promyelocytic leukemia in the all-trans-retinoic acid and arsenic trioxide era, and should be considered once relapse is diagnosed.
KW - Acute promyelocytic leukemia
KW - Acute promyelocytic leukemia relapse
KW - Allogeneic stem cell transplant
KW - Alltrans retinoic acid
KW - Arsenic trioxide
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U2 - 10.3324/haematol.2012.065714
DO - 10.3324/haematol.2012.065714
M3 - Article
C2 - 22689684
AN - SCOPUS:84868557000
VL - 97
SP - 1731
EP - 1735
JO - Haematologica
JF - Haematologica
SN - 0390-6078
IS - 11
ER -