Durable molecular remissions with a single cycle of timed sequential consolidation chemotherapy in acute promyelocytic leukemia

Steven D. Gore, B. Douglas Smith, Ivana Gojo, Michael Grever, Scott H. Kaufmann, Louis Letendre, Debra G.B. Leonard, Guido Marcucci, Carole B. Miller, Lawrence Morris, Steven Piantadosi, Thomas Prior, Wendy Stock, Judith E. Karp

Research output: Contribution to journalArticlepeer-review

Abstract

In a pilot study to reduce the duration of treatment and potential long-term toxicities, 39 patients with acute promyelocytic leukemia in remission received a single cycle of intensive consolidation therapy, followed by intermittent ATRA maintenance. Consolidation therapy required prolonged hospitalization and was associated with a high incidence of mucositis (43% grade II or greater) and documented infection (45%). No deaths occurred during consolidation. Seven patients have relapsed; all other patients are in molecular remission (median follow-up, 2.75 years). Kaplan-Meier estimate of 3 year disease-free survival is 73% (95% confidence interval 55-91%). The relapse rate (0.06 relapses/patient-year of follow-up) is well within the range of larger published series that administer more prolonged consolidation. One patient has developed secondary myelodysplastic syndrome. These pilot data suggest that decreasing the total duration of consolidation chemotherapy did not compromise disease-free survival for APL patients induced with ATRA/ anthracycline and given intermittent ATRA maintenance. However, the toxicity of the consolidation module and the development of secondary myelodysplasia despite decreased total therapy emphasize the need to further improve and refine curative therapy for APL.

Original languageEnglish (US)
Pages (from-to)119-127
Number of pages9
JournalAmerican journal of hematology
Volume79
Issue number2
DOIs
StatePublished - Jun 1 2005

Keywords

  • Acute promyelocytic leukemia
  • Secondary myelodysplasia
  • Timed sequential therapy

ASJC Scopus subject areas

  • Hematology

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