RT Journal Article
T1 Central nervous system involvement at first relapse in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline monochemotherapy without intrathecal prophylaxis.
A1 Montesinos, Pau
A1 Díaz-Mediavilla, Joaquín
A1 Debén, Guillermo
A1 Prates, Virginia
A1 Tormo, Mar
A1 Rubio, Vicente
A1 Pérez, Inmaculada
A1 Fernández, Isolda
A1 Viguria, Maricruz
A1 Rayón, Chelo
A1 González, José
A1 Serna, Javier de la
A1 Esteve, Jordi
A1 Bergua, Juan M
A1 Rivas, Concha
A1 González, Marcos
A1 González, Jose D
A1 Negri, Silvia
A1 Brunet, Salut
A1 Lowenberg, Bob
A1 Sanz, Miguel A
K1 Acute promyelocytic leukemia
K1 Central nervous system relapse
K1 All-trans retinoic acid
K1 Idarubicin
K1 Prognostic factors
K1 Neoplasias del sistema nervioso central
K1 Antibióticos antineoplásicos
K1 Leucemia promielocítica aguda
AB BACKGROUNDThe prevalence of and risk factors for central nervous system recurrence in patients with acute promyelocytic leukemia are not well established and remain a controversial matter.DESIGN AND METHODSBetween 1996 and 2005, 739 patients with newly diagnosed acute promyelocytic leukemia enrolled in two consecutive trials (PETHEMA LPA96 and LPA99) received induction therapy with all-trans retinoic acid and idarubicin. Consolidation therapy comprised three courses of anthracycline monochemotherapy (LPA96), with all-trans retinoic acid and reinforced doses of idarubicin in patients with an intermediate or high risk of relapse (LPA99). Central nervous system prophylaxis was not given.RESULTSCentral nervous system relapse was documented in 11 patients. The 5-year cumulative incidence of central nervous system relapse was 1.7% (LPA96 3.2% and LPA99 1.2%; p=0.09). The cumulative incidence was 0%, 0.8%, and 5.5% in low-, intermediate-, and high-risk patients, respectively. Relapse risk score (p=0.0001) and the occurrence of central nervous system hemorrhage during induction (5-year cumulative incidence 18.7%, p=0.006) were independent risk factors for central nervous system relapse.CONCLUSIONSThis study shows a low incidence of central nervous system relapse in patients with acute promyelocytic leukemia following therapy with all-trans retinoic acid and anthracycline without specific central nervous system prophylaxis. Central nervous system relapse was significantly associated with high white blood cell counts and prior central nervous system hemorrhage, which emerged as independent prognostic factors.
PB Ferrata Storti Foundation
SN 0390-6078
YR 2009
FD 2009-09
LK http://hdl.handle.net/10668/1276
UL http://hdl.handle.net/10668/1276
LA en
NO Montesinos P, Díaz-Mediavilla J, Debén G, Prates V, Tormo M, Rubio V, et al. Central nervous system involvement at first relapse in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline monochemotherapy without intrathecal prophylaxis. Haematologica. 2009; 94(9):1242-9
NO Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't;
DS RISalud
RD Apr 8, 2025