TREATMENT OF ACUTE PROMYELOCYTIC LEUKEMIA WITH AIDA BASED REGIMEN

Ramzi Jeddi, Hèla Ghédira, Ramzi Ben Amor, Yosr Ben Abdennebi, Kacem Karima, Zarrouk Mohamed, Hend Ben Neji, Lamia Aissaoui, Raihane Ben Lakhal, Naouel Ben Salah, Samia Menif, Zaher Belhadjali, Hela Ben Abid, Emna Gouider, Raouf Hafsia, Ali Saad, Pierre Fenaux, Balkis Meddeb
  • Hèla Ghédira
    Affiliation not present
  • Ramzi Ben Amor
    Affiliation not present
  • Yosr Ben Abdennebi
    Affiliation not present
  • Kacem Karima
    Affiliation not present
  • Zarrouk Mohamed
    Affiliation not present
  • Hend Ben Neji
    Affiliation not present
  • Lamia Aissaoui
    Affiliation not present
  • Raihane Ben Lakhal
    Affiliation not present
  • Naouel Ben Salah
    Affiliation not present
  • Samia Menif
    Affiliation not present
  • Zaher Belhadjali
    Affiliation not present
  • Hela Ben Abid
    Affiliation not present
  • Emna Gouider
    Affiliation not present
  • Raouf Hafsia
    Affiliation not present
  • Ali Saad
    Affiliation not present
  • Pierre Fenaux
    Affiliation not present
  • Balkis Meddeb
    Affiliation not present

Abstract

In Tunisia, the ATRA era began in 1998 with the use, consecutively, of two regimens combining ATRA and an anthracycline with cytarabine (APL93), and without cytarabine (LPA99). From 2004, 51 patients with confirmed APL either by t(15;17) or PML/RARA were treated according to the PETHEMA LPA 99 trial. Forty three patients achieved CR (86%). The remaining seven patients had early death (one died before treatment onset): four caused by differentiation syndrome (DS) and three died from central nervous system hemorrhage. Multivariate analysis revealed that female gender (P=0.045), baseline WBC> 10 G/L ( P=0.041) and serum creatinine > 1.4mg/dl ( P=0.021) were predictive of mortality during induction. DS was observed in 16 patients (32%) after a median onset time of 15 days from treatment onset (range, 2–29). Body mass index ≥ 30 (P=0.01) was the only independent predictor of DS. Occurrence of hypertensive peaks significantly predicted occurrence of DS (P=0.011) and was significantly associated with high BMI (p=0.003). With a median follow-up of 50 months, 5 year cumulative incidence of relapse, event free and overall survival were 4.7%, 74% and 78%, respectively.

Keywords

Leukemia

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Submitted: 2014-06-12 16:04:11
Published: 2011-09-08 00:00:00
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