A survival study and prognostic factors analysis on acute promyelocytic leukemia at a single center

Li, Xin; Sun, Wei; Li, Zengjun; Zhao, Yongqiang; Li, Yuntao; Li, Yan; Chang-chun, Wan; Li, Qiaochuan; Yang, Rei‐Cheng; Han, Mingzhe; Wang, Jianxiang; Qiu, Lugui

doi:10.1016/j.leukres.2006.07.028

Cited by 17 publications

(13 citation statements)

References 20 publications

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“…reported that in children and adolescent, female patients with AML t (8), inv(16), or a normal karyotype had better prognosis than males with the same genetic profiles [28]. Findings from the adult literature showed that female AML-MRC patients conferred survival advantage [44,45], outcome was superior in female APL patients [46]. Molecular, genetic and other biological disease features might have contributed to the survival differences between the sexes over AML subtypes [47,48].…”

Section: Discussionmentioning

confidence: 99%

Sex disparity in childhood and young adult acute myeloid leukemia (AML) survival: Evidence from US population data

Hossain

Xie

2015

Cancer Epidemiology

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Sex variation has been persistently investigated in studies concerning acute myeloid leukemia (AML) survival outcomes but has not been fully explored among pediatric and young adult AML patients. We detected sex difference in the survival of AML patients diagnosed at ages 0-24 years and explored distinct effects of sex across subgroups of age at diagnosis, race-ethnicity and AML subtypes utilizing the United States Surveillance Epidemiology and End Results (SEER) population based dataset of 4,865 patients diagnosed with AML between 1973 and 2012. Kaplan-Meier survival function, propensity scores and stratified Cox proportional hazards regression were used for data analyses. After controlling for other prognostic factors, females showed a significant survival advantage over their male counterparts, adjusted hazard ratio (aHR, 95% confidence interval (CI): 1.09, 1.00–1.18). Compared to females, male patients had substantially increased risk of mortality in the following subgroups of: ages 20-24 years at diagnosis (aHR1.30), Caucasian (1.14), acute promyelocytic leukemia (APL) (1.35), acute erythroid leukemia (AEL) (1.39), AML with inv(16)(p13.1q22) (2.57), AML with minimum differentiation (1.47); and had substantially decreased aHR in AML t(9;11)(p22;q23) (0.57) and AML with maturation (0.82). Overall, females demonstrated increased survival over males and this disparity was considerably large in patients ages 20-24 years at diagnosis, Caucasians, and in AML subtypes of AML inv(16), APL and AEL. In contrast, males with AML t(9;11)(p22;q23), AML with maturation and age at diagnosis of 10-14 years showed survival benefit. Further investigations are needed to detect the biological processes influencing the mechanisms of these interactions.

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Section: Discussionmentioning

confidence: 99%

Sex disparity in childhood and young adult acute myeloid leukemia (AML) survival: Evidence from US population data

Hossain

Xie

2015

Cancer Epidemiology

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“…As 2 O 3 has demonstrated remarkable efficacy in APL 16–19. Recently some reports have led to a renewed interest in As 2 O 3 in the management of malignancies,20,21 especially those of hematologic origin, such as MM.…”

Section: Discussionmentioning

confidence: 99%

The clinical activity of arsenic trioxide, ascorbic acid, ifosfamide and prednisone combination therapy in patients with relapsed and refractory multiple myeloma

Sun²

2015

OTT

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This study aimed to investigate the activity of arsenic trioxide (As2O3) combined with ascorbic acid, ifosfamide, and prednisone chemotherapy in patients with repeatedly relapsed and refractory multiple myeloma (MM). Here, we retrospectively analyzed medical data of 30 MM patients showing progressive disease after receiving at least two previous lines of treatment including an immunomodulatory agent (thalidomide or lenalidomide) and a proteasome inhibitor. There were 19 men and eleven women, aged 54–73 (median 65) years, in this study. The distribution of different isotypes included immunoglobulin G(IgG) (12 patients), IgA (six patients), IgD (three), and light chain (nine patients). All the patients were Durie–Salmon stage III and had relapsed at least three times; the median cycles of prior therapies was 15 (range 10–18). The patients were treated with As2O3, ascorbic acid, and CP (ifosfamide 1 g on day 1, day 3, day 5, and day 7; prednisone 30 mg taken orally for 2 weeks). As2O3 was administered as an intravenous infusion at a dose of 10 mg/d and ascorbic acid at a dose of 2 g/d for 14 days of each 4-week cycle. The results showed that after 2 cycles of therapy, there were five patients that attained partial response, 15 had minimal response, five had no change, and five had progressive disease. The overall response rate was 66.7% (20/30 cases), 50% (10/20 cases), and 40% (2/5 cases), respectively, after 2, 4, and 6 cycles of the therapy. But there were no patients that attained complete remission. The median time of overall survival and progression-free survival were 48 (29–120) and 6 (2–8) months, respectively. The most common treatment-related adverse events included neutropenia, fatigue, anemia, thrombocytopenia, and infection that could be tolerated. The results showed that As2O3 combined with ascorbic acid, ifosfamide, and prednisone chemotherapy may be a choice treatment for repeatedly relapsed and refractory MM patients.

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“…Zhang et al [21] reported there was no difference among childhood APL patients treated with ATRA alone or ATO with/ without ATRA for induction regimens in CR rate, 5-year estimate of EFS and OS. Another study [22] showed postremission therapy regimen was among the important prognostic factors for long-term survival and OS. Our study showed similar efficacy of ATO in induction therapy for primary childhood APL as previous results [21] and also showed satisfied outcome of ATO alone with/without minimal CT in post-remission therapy.…”

Section: Discussionmentioning

confidence: 99%

Retrospective study of arsenic trioxide for childhood acute promyelocytic leukemia in China: a single-center experience

et al. 2010

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There are very limited reports about childhood acute promyelocytic leukemia (APL), especially about arsenic trioxide (ATO) treatment in both induction and post-remission regimens. 35 newly diagnosed APL patients received ATO treatment in our center and the clinical course as well as the outcome of them was investigated. The dose of intravenous ATO was 0.15-0.17 mg/kg per day, only one patient got 0.33 mg/kg per day, maximum dose was 10 mg per day in induction therapy with minimal chemotherapy treatment (CT) for hyperleukocytosis. Anthracycline or anthracycline-based CT was used for consolidation therapy and followed by 0.10-0.15 mg/kg per day ATO treatment in maintenance therapy. The continuous detection for morphology of bone marrow and PML-RARa were necessary for administrating CT or not. 3 patients died during induction therapy for intracranial hemorrhage, leukocytosis and septic shock. Total of 30 patients achieved complete remission (CR) and were followed-up for 10-108 months. The overall survival (OS) for all patients was 82.7%, whereas the OS for patients obtained CR was 95.8%. The event-free survival for 5 years was 80.3%. Disseminated intravascular coagulation could be under control to reduce induction mortality with adequate supportive care, especially in the first 2 weeks. The side effects of ATO were mild and transient. This regimen of ATO treatment both in induction and post-remission therapy was effective and safe for childhood APL to get long-term survival.

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A survival study and prognostic factors analysis on acute promyelocytic leukemia at a single center

Cited by 17 publications

References 20 publications

Sex disparity in childhood and young adult acute myeloid leukemia (AML) survival: Evidence from US population data

Sex disparity in childhood and young adult acute myeloid leukemia (AML) survival: Evidence from US population data

The clinical activity of arsenic trioxide, ascorbic acid, ifosfamide and prednisone combination therapy in patients with relapsed and refractory multiple myeloma

Retrospective study of arsenic trioxide for childhood acute promyelocytic leukemia in China: a single-center experience

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