Autologous transplant remains the preferred therapy for relapsed APL in CR2 Journal Article


Authors: Ganzel, C.; Mathews, V.; Alimoghaddam, K.; Ghavamzadeh, A.; Kuk, D.; Devlin, S.; Wang, H.; Zhang, M. J.; Weisdorf, D.; Douer, D.; Rowe, J. M.; Polge, E.; Esteve, J.; Nagler, A.; Mohty, M.; Tallman, M. S.
Article Title: Autologous transplant remains the preferred therapy for relapsed APL in CR2
Abstract: Despite their favorable prognosis, 10-20% of acute promyelocytic leukemia (APL) patients relapse. Reinduction therapy is often followed by autologous hematopoietic cell transplantation (auto-HCT). Arsenic trioxide (ATO) has become part of standard reinduction and is often followed by auto-HCT. Data on patients in CR2 were collected from two large transplant registries (Center for International Blood and Marrow Transplant Research (CIBMTR) and European Group for Blood and Marrow Transplant (EBMT)) and two specialty referral centers. The outcome of patients in CR2 who received only ATO-based therapy as reinduction was retrospectively compared with those who got an auto-HCT, with or without ATO. Prognostic factors included age, disease risk, extramedullary disease and duration of CR1. Of 207 evaluable patients, the median age was 31.5 years, 15.3% had extramedullary disease and median WBC at diagnosis was 4.8 x 10(9)/L. Sixty-seven patients received ATO alone and 140 underwent auto-HCT. The groups were comparable for age, gender, extramedullary disease, risk group and duration of CR1. At 5 years, overall survival (OS) was 42% and 78% for the ATO-only and auto-HCT groups, respectively (P<0.001). In addition, OS was associated with longer duration of CR1 (P= 0.002), but not with disease risk at diagnosis. These data suggest that auto-HCT for APL patients in CR2 results in better OS than ATO-based therapy alone.
Keywords: arsenic trioxide; blood; remission; retinoic acid; acute promyelocytic leukemia; stem-cell transplantation; bone-marrow-transplantation; involvement
Journal Title: Bone Marrow Transplantation
Volume: 51
Issue: 9
ISSN: 0268-3369
Publisher: Nature Publishing Group  
Date Published: 2016-09-01
Start Page: 1180
End Page: 1183
Language: English
ACCESSION: WOS:000383606000004
DOI: 10.1038/bmt.2016.96
PROVIDER: wos
PMCID: PMC5014591
PUBMED: 27088379
Notes: Article -- Source: Wos
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  1. Martin Stuart Tallman
    649 Tallman
  2. Deborah Kuk
    87 Kuk
  3. Dan Douer
    87 Douer
  4. Sean McCarthy Devlin
    601 Devlin