scholarly journals The evolution of arsenic in the treatment of acute promyelocytic leukemia and other myeloid neoplasms: Moving toward an effective oral, outpatient therapy

Cancer ◽  
2015 ◽  
Vol 122 (8) ◽  
pp. 1160-1168 ◽  
Author(s):  
Lorenzo Falchi ◽  
Srdan Verstovsek ◽  
Farhad Ravandi-Kashani ◽  
Hagop M. Kantarjian
Keyword(s):  
Acute Promyelocytic Leukemia ◽  
Promyelocytic Leukemia ◽  
Outpatient Therapy ◽  
Myeloid Neoplasms

Clinical and genetic features of therapy-related myeloid neoplasms after chemotherapy for acute promyelocytic leukemia

Blood ◽  
2010 ◽  
Vol 116 (26) ◽  
pp. 6018-6022 ◽  
Author(s):  
Jun Imagawa ◽  
Yuka Harada ◽  
Takeshi Shimomura ◽  
Hideo Tanaka ◽  
Yoshiko Okikawa ◽  
...  
Keyword(s):  
Complete Remission ◽  
Acute Promyelocytic Leukemia ◽  
Survival Rates ◽  
Promyelocytic Leukemia ◽  
Term Survival ◽  
Cell Counts ◽  
Myeloid Neoplasms ◽  
Hla Dr ◽  
Genetic Features ◽  
White Blood Cell Counts

Abstract Acute promyelocytic leukemia (APL) is a highly curable disease with excellent complete remission and long-term survival rates. However, the development of therapy-related myeloid neoplasms (t-MN) is being reported with increasing frequency in patients successfully treated for APL. We attempted to clarify the different clinical features and hematologic findings between t-MN and relapse cases, and to identify gene alterations involved in t-MN. We compared 10 relapse and 11 t-MN cases that developed in 108 patients during their first complete remission from APL. At APL diagnosis, t-MN patients had lower white blood cell counts than did relapse patients (P = .048). Overall survival starting from chemotherapy was significantly worse in t-MN patients than in relapse patients (P = .022). The t-MN cases were characterized as CD34+/HLA-DR+ and PML-RARA−, and 4 RUNX1/AML1 mutations were detected. T-MN is easily distinguished from APL relapse by evaluating these hematologic features, and it may originate from primitive myeloid cells by chemotherapy-induced RUNX1 mutations.

scholarly journals Therapy-related myeloid neoplasms as a concerning complication in acute promyelocytic leukemia

2017 ◽  
Vol 9 (3) ◽  
Author(s):  
María del Carmen Vicente-Ayuso ◽  
María García-Roa ◽  
Ataúlfo González-Fernández ◽  
Ana María Alvarez-Carmona ◽  
Celina Benavente-Cuesta ◽  
...  
Keyword(s):  
Acute Promyelocytic Leukemia ◽  
Malignant Disease ◽  
Genetic Factors ◽  
Good Prognosis ◽  
Promyelocytic Leukemia ◽  
Maintenance Chemotherapy ◽  
Chemotherapy Treatment ◽  
Chemotherapy Induction ◽  
Myeloid Neoplasms ◽  
Original Clone

Acute promyelocytic leukemia (APL) has become a highly curable malignant disease after the introduction of all transretinoic acid (ATRA) to chemotherapy treatment. However, the risk to develop therapy-related myeloid neoplasms (t-MN) has become a matter of concern, as APL patients are otherwise expected to have a good prognosis. We report a patient with APL who achieved complete remission after chemotherapy induction with anthracycline and ATRA, followed by consolidation and maintenance chemotherapy. Two years later, the patient developed t-AML, with MLL rearrangements, without any evidence of relapse of the APL original clone. The increasing incidence of t-MN in oncohematological patients is partly due to the development of safer, more efficient or targeted therapies, which allow better outcomes and lengthened survival amongst treated patients. The identification of genetic factors, mechanisms or prognostic biomarkers in t-MN might open new windows for the development of personalized targeted therapy regimes in this underserved patient population.

Genetic analysis of therapy-related myeloid neoplasms occurring after intensive treatment for acute promyelocytic leukemia

Leukemia ◽  
2018 ◽  
Vol 32 (9) ◽  
pp. 2066-2069 ◽  
Author(s):  
Aline Renneville ◽  
Philippe Attias ◽  
Xavier Thomas ◽  
Cécile Bally ◽  
Sandrine Hayette ◽  
...  
Keyword(s):  
Genetic Analysis ◽  
Acute Promyelocytic Leukemia ◽  
Promyelocytic Leukemia ◽  
Intensive Treatment ◽  
Myeloid Neoplasms

Therapy-Related Myeloid Neoplasms in Patients With Acute Promyelocytic Leukemia Treated With All-Trans-Retinoic Acid and Anthracycline-Based Chemotherapy

2010 ◽  
Vol 28 (24) ◽  
pp. 3872-3879 ◽  
Author(s):  
Pau Montesinos ◽  
José D. González ◽  
José González ◽  
Chelo Rayón ◽  
Elena de Lisa ◽  
...  
Keyword(s):  
Retinoic Acid ◽  
Acute Promyelocytic Leukemia ◽  
Promyelocytic Leukemia ◽  
Trans Retinoic Acid ◽  
Myeloid Neoplasms ◽  
All Trans Retinoic Acid ◽  
Incidence Risk ◽  
Risk Patients ◽  
Sequential Trials

Purpose We analyzed the incidence, risk factors, and outcome of therapy-related myeloid neoplasms (t-MNs) in patients with acute promyelocytic leukemia (APL) in first complete remission (CR). Patients and Methods From 1996 to 2008, 1,025 patients with APL were enrolled onto three sequential trials (LPA96, LPA99, and LPA2005) of the Programa Español para el Tratamiento de Enfermedades Hematológicas and received induction and consolidation therapy with all-trans-retinoic acid (ATRA) and anthracycline-based chemotherapy. Results Seventeen of 918 patients who achieved CR developed t-MN (10 with < 20% and seven with ≥ 20% of bone marrow blasts) after a median of 43 months from CR. Partial and complete deletions of chromosomes 5 and 7 (nine patients) and 11q23 rearrangements (three patients) were the most common cytogenetic abnormalities. Overall, the 6-year cumulative incidence of t-MN was 2.2%, whereas in low-, intermediate-, and high-risk patients, the 6-year incidence was 5.2%, 2.1%, and 0%, respectively. Multivariate analysis identified age more than 35 years and lower relapse risk score as independent prognostic factors for t-MN. The median overall survival time after t-MN was 10 months. Conclusion t-MN is a relatively infrequent, long-term, and severe complication after first-line treatment for APL with ATRA and anthracycline-based regimens. Therapeutic strategies to reduce the incidence of t-MN are warranted.

Acute promyelocytic leukemia: Clinical and morphologic features and prognostic factors

2001 ◽  
Vol 38 (1) ◽  
pp. 4-12 ◽  
Author(s):  
Giuseppe Avvisati ◽  
Francesco Lo Coco ◽  
Franco Mandelli
Keyword(s):  
Prognostic Factors ◽  
Acute Promyelocytic Leukemia ◽  
Promyelocytic Leukemia
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