Treatment of elderly patients (≥60 years) with newly diagnosed acute promyelocytic leukemia. Results of the Italian multicenter group GIMEMA with ATRA and idarubicin (AIDA) protocols

F. Mandelli, R. Latagliata, G. Avvisati, P. Fazi, F. Rodeghiero, F. Leoni, M. Gobbi, F. Nobile, E. Gallo, R. Fanin, S. Amadori, M. Vignetti, G. Fioritoni, F. Ferrera, A. Peta, R. Giustolisi, G. Broccia, M. C. Petti, F. Lo-Coco

Research output: Contribution to journalArticle

Abstract

In all, 134 elderly patients (median age 66 years, range 60-75 years) with newly diagnosed acute promyelocytic leukemia (APL) were enrolled in two successive protocols of the Italian multicenter group GIMEMA. All patients received an identical induction with all-trans retinoic acid and idarubicin; 116 (86%) entered complete remission (CR), two (2%) were resistant and 16 (12%) died during induction. After CR, 106 patients received further therapy whereas 10 did not, because of refusal (n=5) or toxicity (n = 5). Consolidation consisted of three chemotherapy courses in the AIDA protocol (AIDA, 67 patients) or, since 1997, of an amended protocol including only the first cycle (amended AIDA, aAIDA, 39 patients). In the AIDA group, 43 patients (64%) completed consolidation, while seven (11%) and 17 (25%) patients were withdrawn after first and second courses, respectively; nine patients (13%) died in CR and 12 (18%) relapsed. In the aAIDA group, all patients received the assigned treatment; two patients (5%) died in CR and six (15%) relapsed. In the AIDA and aAIDA series, the 3-year overall and discase-free survival rates were 81 and 83% (P= NS), 73 and 72% (P=NS), respectively. We highlight here the frequency and severity of complications linked to intensive chemotherapy in this clinical setting and suggest that, in APL of the elderly, less intensive postremission therapy allows significant reduction of severe treatment-related toxicity and may be equally effective.

Original languageEnglish
Pages (from-to)1085-1090
Number of pages6
JournalLeukemia
Volume17
Issue number6
DOIs
Publication statusPublished - Jun 1 2003

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Keywords

  • Acute promyelocytic leukemia
  • AML of the elderly
  • ATRA

ASJC Scopus subject areas

  • Hematology
  • Cancer Research

Cite this

Mandelli, F., Latagliata, R., Avvisati, G., Fazi, P., Rodeghiero, F., Leoni, F., Gobbi, M., Nobile, F., Gallo, E., Fanin, R., Amadori, S., Vignetti, M., Fioritoni, G., Ferrera, F., Peta, A., Giustolisi, R., Broccia, G., Petti, M. C., & Lo-Coco, F. (2003). Treatment of elderly patients (≥60 years) with newly diagnosed acute promyelocytic leukemia. Results of the Italian multicenter group GIMEMA with ATRA and idarubicin (AIDA) protocols. Leukemia, 17(6), 1085-1090. https://doi.org/10.1038/sj.leu.2402932