The impact of medical education and networking on the outcome of leukemia treatment in developing countries. The experience of International Consortium on Acute Promyelocytic Leukemia (IC-APL)

Eduardo M. Rego, Haesook T. Kim, Guillermo J. Ruiz-Argüelles, Maria del Rosario Uriarte, Rafael H. Jacomo, Homero Gutiérrez-Aguirre, Raul A M Melo, Rosane Bittencourt, Ricardo Pasquini, Katia Pagnano, Evandro M. Fagundes, Maria de Lourdes Chauffaille, Carlos Chiattone, Lem Martinez, Luis A. Meillón, David Gómez-Almaguer, Hau Kwaan, Javier Garcés-Eisele, Robert Gallagher, Charlotte M. NiemeyerBob Lowenberg, Raul Ribeiro, Francesco LoCoco, Miguel A. Sanz

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: Several clinical trials conducted in Europe and US reported favorable outcomes of patients with APL treated with the combination of all trans retinoic acid (ATRA) and anthracyclines. Nevertheless, the results observed in developing countries with the same regimen was poorer, mainly due to high early mortality mainly due bleeding. The International Consortium on Acute Promyelocytic Leukemia (IC-APL) is an initiative of the International Members Committee of the ASH and the project aims to reduce this gap through the establishment of international network, which was launched in Brazil, Mexico and Uruguay. Methods: The IC-APL treatment protocol is similar to the PETHEMA 2005, but changing idarubicin to daunorubicin. All patients with a suspected diagnosis of APL were immediately started on ATRA, while bone marrow samples were shipped to a national central lab where genetic verification of the diagnosis was performed. The immunofluorescence using an anti-PML antibody allowed a rapid confirmation of the diagnosis and, the importance of supportive measures was reinforced. Results: The interim analysis of 97 patients enrolled in the IC-APL protocol showed that complete remission (CR) rate was 83% and the 2-year overall survival and disease-free survival were 80% and 90%, respectively. Of note, the early mortality rate was reduced to 7.5%. Discussion: The results of IC-APL demonstrate the impact of educational programs and networking on the improvement of the leukemia treatment outcome in developing countries.

Original languageEnglish
JournalHematology
Volume17
Issue numberSUPPL. 1
DOIs
Publication statusPublished - Apr 2012

Fingerprint

Acute Promyelocytic Leukemia
Medical Education
Developing Countries
Leukemia
Tretinoin
Idarubicin
Committee Membership
Uruguay
Daunorubicin
Mortality
Anthracyclines
Clinical Protocols
Mexico
Disease-Free Survival
Fluorescent Antibody Technique
Brazil
Anti-Idiotypic Antibodies
Bone Marrow
Clinical Trials
Hemorrhage

Keywords

  • Acute promyelocytic leukemia
  • All trans retinoic acid
  • Developing countries
  • Leukemia

ASJC Scopus subject areas

  • Hematology

Cite this

The impact of medical education and networking on the outcome of leukemia treatment in developing countries. The experience of International Consortium on Acute Promyelocytic Leukemia (IC-APL). / Rego, Eduardo M.; Kim, Haesook T.; Ruiz-Argüelles, Guillermo J.; Uriarte, Maria del Rosario; Jacomo, Rafael H.; Gutiérrez-Aguirre, Homero; Melo, Raul A M; Bittencourt, Rosane; Pasquini, Ricardo; Pagnano, Katia; Fagundes, Evandro M.; Chauffaille, Maria de Lourdes; Chiattone, Carlos; Martinez, Lem; Meillón, Luis A.; Gómez-Almaguer, David; Kwaan, Hau; Garcés-Eisele, Javier; Gallagher, Robert; Niemeyer, Charlotte M.; Lowenberg, Bob; Ribeiro, Raul; LoCoco, Francesco; Sanz, Miguel A.

In: Hematology, Vol. 17, No. SUPPL. 1, 04.2012.

Research output: Contribution to journalArticle

Rego, EM, Kim, HT, Ruiz-Argüelles, GJ, Uriarte, MDR, Jacomo, RH, Gutiérrez-Aguirre, H, Melo, RAM, Bittencourt, R, Pasquini, R, Pagnano, K, Fagundes, EM, Chauffaille, MDL, Chiattone, C, Martinez, L, Meillón, LA, Gómez-Almaguer, D, Kwaan, H, Garcés-Eisele, J, Gallagher, R, Niemeyer, CM, Lowenberg, B, Ribeiro, R, LoCoco, F & Sanz, MA 2012, 'The impact of medical education and networking on the outcome of leukemia treatment in developing countries. The experience of International Consortium on Acute Promyelocytic Leukemia (IC-APL)', Hematology, vol. 17, no. SUPPL. 1. https://doi.org/10.1179/102453312X13336169155376
Rego, Eduardo M. ; Kim, Haesook T. ; Ruiz-Argüelles, Guillermo J. ; Uriarte, Maria del Rosario ; Jacomo, Rafael H. ; Gutiérrez-Aguirre, Homero ; Melo, Raul A M ; Bittencourt, Rosane ; Pasquini, Ricardo ; Pagnano, Katia ; Fagundes, Evandro M. ; Chauffaille, Maria de Lourdes ; Chiattone, Carlos ; Martinez, Lem ; Meillón, Luis A. ; Gómez-Almaguer, David ; Kwaan, Hau ; Garcés-Eisele, Javier ; Gallagher, Robert ; Niemeyer, Charlotte M. ; Lowenberg, Bob ; Ribeiro, Raul ; LoCoco, Francesco ; Sanz, Miguel A. / The impact of medical education and networking on the outcome of leukemia treatment in developing countries. The experience of International Consortium on Acute Promyelocytic Leukemia (IC-APL). In: Hematology. 2012 ; Vol. 17, No. SUPPL. 1.
@article{191d17c9febd4fa48e79b995ad68a238,
title = "The impact of medical education and networking on the outcome of leukemia treatment in developing countries. The experience of International Consortium on Acute Promyelocytic Leukemia (IC-APL)",
abstract = "Objectives: Several clinical trials conducted in Europe and US reported favorable outcomes of patients with APL treated with the combination of all trans retinoic acid (ATRA) and anthracyclines. Nevertheless, the results observed in developing countries with the same regimen was poorer, mainly due to high early mortality mainly due bleeding. The International Consortium on Acute Promyelocytic Leukemia (IC-APL) is an initiative of the International Members Committee of the ASH and the project aims to reduce this gap through the establishment of international network, which was launched in Brazil, Mexico and Uruguay. Methods: The IC-APL treatment protocol is similar to the PETHEMA 2005, but changing idarubicin to daunorubicin. All patients with a suspected diagnosis of APL were immediately started on ATRA, while bone marrow samples were shipped to a national central lab where genetic verification of the diagnosis was performed. The immunofluorescence using an anti-PML antibody allowed a rapid confirmation of the diagnosis and, the importance of supportive measures was reinforced. Results: The interim analysis of 97 patients enrolled in the IC-APL protocol showed that complete remission (CR) rate was 83{\%} and the 2-year overall survival and disease-free survival were 80{\%} and 90{\%}, respectively. Of note, the early mortality rate was reduced to 7.5{\%}. Discussion: The results of IC-APL demonstrate the impact of educational programs and networking on the improvement of the leukemia treatment outcome in developing countries.",
keywords = "Acute promyelocytic leukemia, All trans retinoic acid, Developing countries, Leukemia",
author = "Rego, {Eduardo M.} and Kim, {Haesook T.} and Ruiz-Arg{\"u}elles, {Guillermo J.} and Uriarte, {Maria del Rosario} and Jacomo, {Rafael H.} and Homero Guti{\'e}rrez-Aguirre and Melo, {Raul A M} and Rosane Bittencourt and Ricardo Pasquini and Katia Pagnano and Fagundes, {Evandro M.} and Chauffaille, {Maria de Lourdes} and Carlos Chiattone and Lem Martinez and Meill{\'o}n, {Luis A.} and David G{\'o}mez-Almaguer and Hau Kwaan and Javier Garc{\'e}s-Eisele and Robert Gallagher and Niemeyer, {Charlotte M.} and Bob Lowenberg and Raul Ribeiro and Francesco LoCoco and Sanz, {Miguel A.}",
year = "2012",
month = "4",
doi = "10.1179/102453312X13336169155376",
language = "English",
volume = "17",
journal = "Hematology",
issn = "1024-5332",
publisher = "Taylor and Francis Ltd.",
number = "SUPPL. 1",

}

TY - JOUR

T1 - The impact of medical education and networking on the outcome of leukemia treatment in developing countries. The experience of International Consortium on Acute Promyelocytic Leukemia (IC-APL)

AU - Rego, Eduardo M.

AU - Kim, Haesook T.

AU - Ruiz-Argüelles, Guillermo J.

AU - Uriarte, Maria del Rosario

AU - Jacomo, Rafael H.

AU - Gutiérrez-Aguirre, Homero

AU - Melo, Raul A M

AU - Bittencourt, Rosane

AU - Pasquini, Ricardo

AU - Pagnano, Katia

AU - Fagundes, Evandro M.

AU - Chauffaille, Maria de Lourdes

AU - Chiattone, Carlos

AU - Martinez, Lem

AU - Meillón, Luis A.

AU - Gómez-Almaguer, David

AU - Kwaan, Hau

AU - Garcés-Eisele, Javier

AU - Gallagher, Robert

AU - Niemeyer, Charlotte M.

AU - Lowenberg, Bob

AU - Ribeiro, Raul

AU - LoCoco, Francesco

AU - Sanz, Miguel A.

PY - 2012/4

Y1 - 2012/4

N2 - Objectives: Several clinical trials conducted in Europe and US reported favorable outcomes of patients with APL treated with the combination of all trans retinoic acid (ATRA) and anthracyclines. Nevertheless, the results observed in developing countries with the same regimen was poorer, mainly due to high early mortality mainly due bleeding. The International Consortium on Acute Promyelocytic Leukemia (IC-APL) is an initiative of the International Members Committee of the ASH and the project aims to reduce this gap through the establishment of international network, which was launched in Brazil, Mexico and Uruguay. Methods: The IC-APL treatment protocol is similar to the PETHEMA 2005, but changing idarubicin to daunorubicin. All patients with a suspected diagnosis of APL were immediately started on ATRA, while bone marrow samples were shipped to a national central lab where genetic verification of the diagnosis was performed. The immunofluorescence using an anti-PML antibody allowed a rapid confirmation of the diagnosis and, the importance of supportive measures was reinforced. Results: The interim analysis of 97 patients enrolled in the IC-APL protocol showed that complete remission (CR) rate was 83% and the 2-year overall survival and disease-free survival were 80% and 90%, respectively. Of note, the early mortality rate was reduced to 7.5%. Discussion: The results of IC-APL demonstrate the impact of educational programs and networking on the improvement of the leukemia treatment outcome in developing countries.

AB - Objectives: Several clinical trials conducted in Europe and US reported favorable outcomes of patients with APL treated with the combination of all trans retinoic acid (ATRA) and anthracyclines. Nevertheless, the results observed in developing countries with the same regimen was poorer, mainly due to high early mortality mainly due bleeding. The International Consortium on Acute Promyelocytic Leukemia (IC-APL) is an initiative of the International Members Committee of the ASH and the project aims to reduce this gap through the establishment of international network, which was launched in Brazil, Mexico and Uruguay. Methods: The IC-APL treatment protocol is similar to the PETHEMA 2005, but changing idarubicin to daunorubicin. All patients with a suspected diagnosis of APL were immediately started on ATRA, while bone marrow samples were shipped to a national central lab where genetic verification of the diagnosis was performed. The immunofluorescence using an anti-PML antibody allowed a rapid confirmation of the diagnosis and, the importance of supportive measures was reinforced. Results: The interim analysis of 97 patients enrolled in the IC-APL protocol showed that complete remission (CR) rate was 83% and the 2-year overall survival and disease-free survival were 80% and 90%, respectively. Of note, the early mortality rate was reduced to 7.5%. Discussion: The results of IC-APL demonstrate the impact of educational programs and networking on the improvement of the leukemia treatment outcome in developing countries.

KW - Acute promyelocytic leukemia

KW - All trans retinoic acid

KW - Developing countries

KW - Leukemia

UR - http://www.scopus.com/inward/record.url?scp=84859768294&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859768294&partnerID=8YFLogxK

U2 - 10.1179/102453312X13336169155376

DO - 10.1179/102453312X13336169155376

M3 - Article

C2 - 22507775

AN - SCOPUS:84859768294

VL - 17

JO - Hematology

JF - Hematology

SN - 1024-5332

IS - SUPPL. 1

ER -