Abstract
After the identification of discrete relapse-risk categories in patients with acute promyelocytic leukemia (APL) receiving alltrans retinoic and idarubicin (AIDA)-like therapies, the Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA) designed a protocol for newly diagnosed APL (AIDA-2000) in which postremission treatment was risk-adapted. Patients with low/intermediate risk received remission at 3 anthracycline-based consolidation courses, whereas high-risk patients received the same schedule as in the previous, non-risk-adapted AIDA-0493 trial including cytarabine.In addition, all patients in the AIDA-2000 received all-trans retinoic acid (ATRA) for 15 days during each consolidation. After induction, 600 of 636 (94.3%) and 420 of 445 (94.4%) patients achieved complete remission in the AIDA-0493 and AIDA-2000, respectively. The 6-year overall survival and cumulative incidence of relapse (CIR) rates were 78.1% versus 87.4% (P = .001) and 27.7% versus 10.7% (P <.0001). Significantly lower CIR rates for patients in the AIDA-2000 were most evident in the high-risk group (49.7% vs 9.3%, respectively, P <.0001). Our data confirm that anthracycline-based consolidation is at least equally effective as cytarabine-containing regimens for low-/intermediate-risk patients and suggest that a risk-adapted strategy including ATRA for consolidation improves outcome in newly diagnosed APL. Furthermore, our results highlight the role of cytarabine coupled to anthracyclines and ATRA during consolidation in the high-risk group. This trial was registered at www.clinicaltrials.gov as #NCT 001064570.
| Original language | English |
|---|---|
| Pages (from-to) | 3171-3179 |
| Number of pages | 9 |
| Journal | Blood |
| Volume | 116 |
| Issue number | 17 |
| DOIs | |
| Publication status | Published - Oct 28 2010 |
Fingerprint
ASJC Scopus subject areas
- Hematology
- Biochemistry
- Cell Biology
- Immunology
Cite this
Front-line treatment of acute promyelocytic leukemia with AIDA induction followed by risk-adapted consolidation for adults younger than 61 years : Results of the AIDA-2000 trial of the GIMEMA Group. / Lo-Coco, Francesco; Avvisati, Giuseppe; Vignetti, Marco; Breccia, Massimo; Gallo, Eugenio; Rambaldi, Alessandro; Paoloni, Francesca; Fioritoni, Giuseppe; Ferrara, Felicetto; Specchia, Giorgina; Cimino, Giuseppe; Diverio, Daniela; Borlenghi, Erika; Martinelli, Giovanni; Di Raimondo, Francesco; Di Bona, Eros; Fazi, Paola; Peta, Antonio; Bosi, Alberto; Carella, Angelo M.; Fabbiano, Francesco; Pogliani, Enrico M.; Petti, Maria C.; Amadori, Sergio; Mandelli, Franco.
In: Blood, Vol. 116, No. 17, 28.10.2010, p. 3171-3179.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Front-line treatment of acute promyelocytic leukemia with AIDA induction followed by risk-adapted consolidation for adults younger than 61 years
T2 - Results of the AIDA-2000 trial of the GIMEMA Group
AU - Lo-Coco, Francesco
AU - Avvisati, Giuseppe
AU - Vignetti, Marco
AU - Breccia, Massimo
AU - Gallo, Eugenio
AU - Rambaldi, Alessandro
AU - Paoloni, Francesca
AU - Fioritoni, Giuseppe
AU - Ferrara, Felicetto
AU - Specchia, Giorgina
AU - Cimino, Giuseppe
AU - Diverio, Daniela
AU - Borlenghi, Erika
AU - Martinelli, Giovanni
AU - Di Raimondo, Francesco
AU - Di Bona, Eros
AU - Fazi, Paola
AU - Peta, Antonio
AU - Bosi, Alberto
AU - Carella, Angelo M.
AU - Fabbiano, Francesco
AU - Pogliani, Enrico M.
AU - Petti, Maria C.
AU - Amadori, Sergio
AU - Mandelli, Franco
PY - 2010/10/28
Y1 - 2010/10/28
N2 - After the identification of discrete relapse-risk categories in patients with acute promyelocytic leukemia (APL) receiving alltrans retinoic and idarubicin (AIDA)-like therapies, the Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA) designed a protocol for newly diagnosed APL (AIDA-2000) in which postremission treatment was risk-adapted. Patients with low/intermediate risk received remission at 3 anthracycline-based consolidation courses, whereas high-risk patients received the same schedule as in the previous, non-risk-adapted AIDA-0493 trial including cytarabine.In addition, all patients in the AIDA-2000 received all-trans retinoic acid (ATRA) for 15 days during each consolidation. After induction, 600 of 636 (94.3%) and 420 of 445 (94.4%) patients achieved complete remission in the AIDA-0493 and AIDA-2000, respectively. The 6-year overall survival and cumulative incidence of relapse (CIR) rates were 78.1% versus 87.4% (P = .001) and 27.7% versus 10.7% (P <.0001). Significantly lower CIR rates for patients in the AIDA-2000 were most evident in the high-risk group (49.7% vs 9.3%, respectively, P <.0001). Our data confirm that anthracycline-based consolidation is at least equally effective as cytarabine-containing regimens for low-/intermediate-risk patients and suggest that a risk-adapted strategy including ATRA for consolidation improves outcome in newly diagnosed APL. Furthermore, our results highlight the role of cytarabine coupled to anthracyclines and ATRA during consolidation in the high-risk group. This trial was registered at www.clinicaltrials.gov as #NCT 001064570.
AB - After the identification of discrete relapse-risk categories in patients with acute promyelocytic leukemia (APL) receiving alltrans retinoic and idarubicin (AIDA)-like therapies, the Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA) designed a protocol for newly diagnosed APL (AIDA-2000) in which postremission treatment was risk-adapted. Patients with low/intermediate risk received remission at 3 anthracycline-based consolidation courses, whereas high-risk patients received the same schedule as in the previous, non-risk-adapted AIDA-0493 trial including cytarabine.In addition, all patients in the AIDA-2000 received all-trans retinoic acid (ATRA) for 15 days during each consolidation. After induction, 600 of 636 (94.3%) and 420 of 445 (94.4%) patients achieved complete remission in the AIDA-0493 and AIDA-2000, respectively. The 6-year overall survival and cumulative incidence of relapse (CIR) rates were 78.1% versus 87.4% (P = .001) and 27.7% versus 10.7% (P <.0001). Significantly lower CIR rates for patients in the AIDA-2000 were most evident in the high-risk group (49.7% vs 9.3%, respectively, P <.0001). Our data confirm that anthracycline-based consolidation is at least equally effective as cytarabine-containing regimens for low-/intermediate-risk patients and suggest that a risk-adapted strategy including ATRA for consolidation improves outcome in newly diagnosed APL. Furthermore, our results highlight the role of cytarabine coupled to anthracyclines and ATRA during consolidation in the high-risk group. This trial was registered at www.clinicaltrials.gov as #NCT 001064570.
UR - http://www.scopus.com/inward/record.url?scp=77958499078&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77958499078&partnerID=8YFLogxK
U2 - 10.1182/blood-2010-03-276196
DO - 10.1182/blood-2010-03-276196
M3 - Article
VL - 116
SP - 3171
EP - 3179
JO - Blood
JF - Blood
SN - 0006-4971
IS - 17
ER -