Induction therapy with idarubicin alone significantly influences event-free survival duration in patients with newly diagnosed hypergranular acute promyelocytic leukemia: final results of the GIMEMA randomized study LAP 0389 with 7 years of minimal follow-up

Abstract

Shortly before the all-trans retinoic acid (ATRA) era, the GIMEMA cooperative group initiated a randomized study comparing idarubicin (

All-trans retinoic acid/As 2 O 3 combination yields a high quality remission and survival in newly diagnosed acute promyelocytic leukemia

“…It is also characterized by the t(15;17)(q22;q21) chromosome translocation generating the PML-RAR␣ (promyelocytic leukemia-retinoic acid receptor ␣) fusion gene, of which the leukemogenic role has been demonstrated by the transgenic mouse models (1). Although conventional chemotherapy such as anthracyclines and cytosine arabinoside (ara-C) succeeded in two-thirds of APL patients in obtaining complete remission, high frequency of early death mainly due to exacerbation of bleeding syndrome and low 5-year diseasefree survival (DFS) rates dwarf them to new drugs (2). Our group in the Shanghai Institute of Hematology (SIH) has long been interested in differentiation therapy of human cancers, as inspired by the Chinese philosophy that it is better to transform a bad element instead of simply getting rid of it.…”

Leucemia promielocítica aguda: Resultados del protocolo terapéutico LPA2000, Programa Nacional de Cáncer del Adulto (PANDA), Ministerio de Salud, Chile

“…Aunque la SLR de 84% es similar, a lo referido por el grupo PETHEMA y otros grupos europeos, la SG de 64% es francamente inferior al 85-97% que reportan a 3 años [9][10][11][26][27][28] . Esta diferencia se explica por una elevada mortalidad relacionada a tratamiento tanto en inducción como en consolidación.…”

Curative Strategies in Acute Promyelocytic Leukemia

“…18,19 This strategy was supported by Bernard's initial study 7 and by a prospective randomized trial conducted by the Italian cooperative group Gruppo Italiano Malatte Ematologiche dell'Adulto (GIMEMA) in the pre-ATRA era showing no advantage to the addition of ara-C to idarubicin in patients with newly diagnosed APL. 20 The disease-free survival (DFS) without ara-C varied between 81% for patients receiving standard doses of idarubicin and 90% when intermediate-and highrisk patients were given higher doses of idarubicin (riskadapted therapy, discussed below).…”