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Acute promyelocytic leukemia. Therapy results and prognostic factors
Author(s) -
Sanz Miguel A.,
Jarque Isidro,
Martín Guillermo,
Lorenzo Ignacio,
Martínez Jesús,
Rafecas Javier,
Pastor Emilio,
Sayas María José,
Sanz Guillermo,
Gomis Federico
Publication year - 1988
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19880101)61:1<7::aid-cncr2820610103>3.0.co;2-6
Subject(s) - medicine , acute promyelocytic leukemia , daunorubicin , gastroenterology , methotrexate , maintenance therapy , acute myeloblastic leukemia , creatinine , cytarabine , surgery , leukemia , acute leukemia , chemotherapy , biochemistry , retinoic acid , chemistry , gene
From December 1976 to July 1986, 34 patients with acute promyelocytic leukemia (APL) were treated with daunorubicin (DNR) alone and simultaneous supportive therapy with low‐dose heparin, platelet transfusions, and fresh frozen plasma. Two consecutive maintenance therapy regimens were employed in patients who achieved complete remission (CR): (1) a classical maintenance with methotrexate and 6‐mercaptopurine, with DNR plus methyl‐GAG reinductions; (2) from 1982 an intensive sequential combination therapy regimen was administered. CR was achieved in 23 patients (68%). Only one patient had leukemic resistance. Other failures were a consequence of postchemotherapy complications. A multivariate logistic regression analysis has been performed to evaluate the prognostic importance on response to remission induction of 25 patient and disease characteristics at diagnosis. The significant variables in decreasing order of significance were: serum albumin level, fever at diagnosis, serum creatinine level, and age. The median duration of remission and survival by Kaplan‐Meier analysis were projected to be 24 and 25 months, respectively. Relapses occurred in 11 of 23 CR patients. Nine patients remained in the first remission from 5+ to 37+ months. Short‐term (CR) and long‐term results (duration of remission and survival) in APL treated for induction with DNR alone were similar to those obtained in other subtypes of acute myeloblastic leukemia by intensive combination chemotherapy.