Autologous hematopoietic cell transplantation for acute promyelocytic leukemia in second complete remission: outcomes before and after the introduction of arsenic trioxide

Yanada, Masamitsu; Yano, Shingo; Kanamori, Heiwa; Gotoh, Moritaka; Emi, Nobuhiko; Watakabe, Kyoko; Kurokawa, Mineo; Nishikawa, Akinori; Mori, Takehiko; Tomita, Naoto; Murata, Makoto; Hashimoto, Hisako; Henzan, Hideho; Kanda, Yoshinobu; Sawa, Masashi; Kohno, Akio; Atsuta, Yoshiko; Ichinohe, Tatsuo; Takami, Akiyoshi

doi:10.1080/10428194.2016.1231406

Cited by 23 publications

(23 citation statements)

References 30 publications

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“…Regardless of scenario, the main objective of salvage therapy is the achievement of molecular remission as a bridge to HSCT. Based on recent studies, [57][58][59][60][61][62] autologous HSCT should be considered the first choice for eligible patients achieving second molecular remission. However, a recent NCRI report questions the role of transplantation, at least in patients achieving molecular remission with ATO and ATRA who do not have CNS disease at relapse and who have received a full course of consolidation with ATO.…”

Section: Management Of Molecular and Hematologic Relapsementioning

confidence: 99%

Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet

Sanz

Fenaux

Tallman

et al. 2019

Blood

448

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Since the comprehensive recommendations for the management of acute promyelocytic leukemia (APL) reported in 2009, several studies have provided important insights, particularly regarding the role of arsenic trioxide (ATO) in frontline therapy. Ten years later, a European LeukemiaNet expert panel has reviewed the recent advances in the management of APL in both frontline and relapse settings in order to develop updated evidence- and expert opinion–based recommendations on the management of this disease. Together with providing current indications on genetic diagnosis, modern risk-adapted frontline therapy, and salvage treatment, the review contains specific recommendations for the identification and management of the most important complications such as the bleeding disorder APL differentiation syndrome, QT prolongation, and other all-trans retinoic acid– and ATO-related toxicities, as well as recommendations for molecular assessment of the response to treatment. Finally, the approach to special situations is also discussed, including management of APL in children, elderly patients, and pregnant women. The most important challenges remaining in APL include early death, which still occurs before and during induction therapy, and optimizing treatment in patients with high-risk disease.

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Section: Management Of Molecular and Hematologic Relapsementioning

confidence: 99%

Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet

Sanz

Fenaux

Tallman

et al. 2019

Blood

448

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“…The Latino-American population represents the major proportion of affected population (Testi et al 2014). Despite the advances in APL therapy, 20% of patients present relapsed disease, and for these patients As 2 O 3 was found to be the standard treatment (Yanada et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Arsenic trioxide exposure impairs testicular morphology in adult male mice and consequent fetus viability

Silva

Borges

Lamas

et al. 2017

Journal of Toxicology and Environmental Health, Part A

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The acute promyelocytic leukemia (APL) is a rare disease, affecting 0.1/100,000 individuals globally. Despite significant advances in APL therapy, some patients still experience relapsed disease. Currently, arsenic trioxide (AsO) was found to be effective in relapsed APL treatment and considered as standard treatment for these cases. However, it has been shown that exposure to AsO may exert adverse effects on the male reproductive system since this substance might also induce apoptosis of other important cell types including stem cells. Studies demonstrated that treatment with this metallic substance decreased plasma levels of testosterone and interfered with sperm parameters such as concentration, motility, and viability. In addition, AsO was found to produce significant damage to spermatocytes, which may be associated with testicular toxicity and consequent inhibition of spermatogenesis. The aim of this study was to determine sub-chronic treatment effects of AsO on sperm and testicular morphology, androgen receptor (AR) immunoreactivity in testes and epididymis, in addition to evaluation of fertility parameters in adult male mice. Thirty adult Swiss mice were divided into three experimental groups: control; received distilled water (vehicle) while treated received 0.3 or 3 mg/kg/day AsO subcutaneously, for 5 days per week, followed by 2 days of interruption, for 5 weeks. Results showed that AsO (1) decreased spermatozoa number, (2) produced seminiferous epithelium degeneration and exfoliation of germ cells tubule lumen (3) altered nucleus/cytoplasm proportion of Leydig cells and (4) reduced AR immunoreactivity in both Leydig and epithelial epididymal cells. Further, fetal viability tests demonstrated an increase in post-implantation loss in females that were mated with AsO-treated males. Data indicate that AsO exposure altered the spermatogenic process and subsequently fetal viability.

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“…reported strategies for treating APL after the first relapse, including the use of ATO for reinduction and auto‐HSCT during the CR2 . They also reported that the annual number of auto‐HSCT has increased since 2005 (ATO era), and that there have been significant improvements in the DFS and OS of patients who undergo auto‐HSCT during their CR2 since ATO has become clinically available . There have been few reports about relapsed pediatric APL .…”

Section: Discussionmentioning

confidence: 99%

“…12 They also reported that the annual number of auto-HSCT has increased since 2005 (ATO era), and that there have been significant improvements in the DFS and OS of patients who undergo auto-HSCT during their CR2 since ATO has become clinically available. 23 There have been few reports about relapsed pediatric APL. 17,24 Dvorak et al reported there was no significant difference in DFS or OS between auto-HSCT and allo-HSCT, although the RI was much higher after auto-HSCT than after allo-HSCT.…”

Section: Sanz Et Al Reported That the 5ydfs Of Adult Patients Who Unmentioning

confidence: 99%

Hematopoietic stem cell transplantation for pediatric acute promyelocytic leukemia in Japan

Yamamoto

Tomizawa

Kudo

et al. 2020

Pediatric Blood & Cancer

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Background The number of hematopoietic stem cell transplantation (HSCT) procedures performed for pediatric acute promyelocytic leukemia (APL) has decreased in the all‐trans retinoic acid (ATRA) era. Although HSCT is still widely adopted as part of salvage therapy for relapsed patients, there is no general consensus about the optimal transplant type (autologous [auto‐HSCT] or allogeneic HSCT [allo‐HSCT]). Procedures We retrospectively reviewed the clinical data of 95 childhood APL patients who underwent their first HSCT between 1990 and 2014. Of the 95 patients, 40 (42%), 41 (43%), and 3 (3%) underwent HSCT procedures after achieving their first complete remission (CR1), CR2, and CR3, respectively, and 11 (12%) underwent HSCT while in a non‐CR state. Results The non‐CR group exhibited significantly worse five‐year overall survival (5yOS) and disease‐free survival (5yDFS) (5yOS: 46%; 5yDFS: 46%) than the CR1 (5yOS: 80%; 5yDFS: 78%) and CR2 + CR3 groups (5yOS: 81%; 5yDFS: 76%) (P = 0.013 and P < 0.01, respectively). Of the patients treated in CR2, no significant differences in 5yOS or the five‐year cumulative incidence of relapse (5yRI) were detected between the auto‐HSCT and allo‐HSCT groups (5yOS: 85%, vs 78%, P = 0.648; 5yRI: 9%, vs 11%, P = 0.828). Among the patients who underwent allo‐HSCT in CR2, those with matched sibling donors displayed a significantly higher 5yRI (33%) than those with other types of donors (0%, P = 0.015). Conclusions Even after relapsing, childhood APL can be cured with HSCT if CR is achieved. These findings demonstrate that achieving CR followed by HSCT is the preferred strategy for treating children with relapsed or refractory APL.

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Autologous hematopoietic cell transplantation for acute promyelocytic leukemia in second complete remission: outcomes before and after the introduction of arsenic trioxide

Cited by 23 publications

References 30 publications

Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet

Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet

Arsenic trioxide exposure impairs testicular morphology in adult male mice and consequent fetus viability

Hematopoietic stem cell transplantation for pediatric acute promyelocytic leukemia in Japan

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