[Therapeutic results with apl 93 protocol in acute promyelocytic leukemia (34 cases)]

Tunis Med. 2006 Nov;84(11):717-20.
[Article in French]

Abstract

Background: Acute promyelocytic leukaemia (APL) account for approximately 10% to 15% of all AML in most reports. Clinical features includes the presence in 80% to 90% of patients of a severe hemorrhagic syndrome, a specific balanced translocation between chromosomes 15 and 17 with a fusion of a large pert of the retinoic acid receptor a gene (RARa) on chromosome 17 to a part of the promyelocytic leukaemia (PML) gene on chromosome 15. More than 75% of patients (under 65 years of age) can be cured, with the application of a combination of anthracyclines and all-trans retinoic acid (ATRA), followed by maintenance therapy.

Aim: of the study was to assess of the therapeutic management of APL 93 protocol in acute promyelocytic leukemia.

Methods: We present here the results of a retrospective study concerning 34 patients with APL included between 1998 and 2004 in the APL 93 protocol : 20 in group B and 14 in group C. CR was 82 %.

Results: Failure is only due to toxic death (18%) Event free survival at 4 years is 63,47% with relapse rate at 14.25%. Overall survival at 4 years is 69,72%. Our results are acceptable and can be improved with reduction of failure due to toxic death, probably with omission of cytarabine from induction and consolidation adapted by the Spanish PETHEMA Group.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Anthracyclines / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Child
  • Chromosomes, Human, Pair 15 / genetics
  • Chromosomes, Human, Pair 17 / genetics
  • Female
  • Humans
  • Leukemia, Promyelocytic, Acute / diagnosis
  • Leukemia, Promyelocytic, Acute / drug therapy*
  • Leukemia, Promyelocytic, Acute / genetics
  • Leukemia, Promyelocytic, Acute / mortality
  • Male
  • Middle Aged
  • Pilot Projects
  • Receptors, Retinoic Acid
  • Remission Induction
  • Retinoic Acid Receptor alpha
  • Retrospective Studies
  • Survival Analysis
  • Translocation, Genetic
  • Tretinoin / administration & dosage
  • Tunisia

Substances

  • Anthracyclines
  • RARA protein, human
  • Receptors, Retinoic Acid
  • Retinoic Acid Receptor alpha
  • Tretinoin