After the identification of discrete relapse-risk categories in patients with acute promyelocytic leukemia (APL) receiving all-trans retinoic and idarubicin (AIDA)-like therapies, the Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA) designed a protocol for newly diagnosed APL (AIDA-2000) in which postremission treatment was risk-adapted. Patients with low/intermediate risk received remission at 3 anthracycline-based consolidation courses, whereas high-risk patients received the same schedule as in the previous, non-risk-adapted AIDA-0493 trial including cytarabine. In addition, all patients in the AIDA-2000 received all-trans retinoic acid (ATRA) for 15 days during each consolidation. After induction, 600 of 636 (94.3%) and 420 of 445 (94.4%) patients achieved complete remission in the AIDA-0493 and AIDA-2000, respectively. The 6-year overall survival and cumulative incidence of relapse (CIR) rates were 78.1% versus 87.4% (P = .001) and 27.7% versus 10.7% (P < .0001). Significantly lower CIR rates for patients in the AIDA-2000 were most evident in the high-risk group (49.7% vs 9.3%, respectively, P < .0001). Our data confirm that anthracycline-based consolidation is at least equally effective as cytarabine-containing regimens for low-/intermediate-risk patients and suggest that a risk-adapted strategy including ATRA for consolidation improves outcome in newly diagnosed APL. Furthermore, our results highlight the role of cytarabine coupled to anthracyclines and ATRA during consolidation in the high-risk group.

LO COCO, F., Avvisati, G., Vignetti, M., Breccia, M., Gallo, E., Rambaldi, A., et al. (2010). Front-line treatment of acute promyelocytic leukemia with AIDA induction followed by risk-adapted consolidation for adult patients younger than 61 years: results of the AIDA-2000 trial of the GIMEMA group. BLOOD, 116(17), 3171-3179 [10.1182/blood-2010-03-276196].

Front-line treatment of acute promyelocytic leukemia with AIDA induction followed by risk-adapted consolidation for adult patients younger than 61 years: results of the AIDA-2000 trial of the GIMEMA group

LO COCO, FRANCESCO;AMADORI, SERGIO;
2010-01-01

Abstract

After the identification of discrete relapse-risk categories in patients with acute promyelocytic leukemia (APL) receiving all-trans retinoic and idarubicin (AIDA)-like therapies, the Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA) designed a protocol for newly diagnosed APL (AIDA-2000) in which postremission treatment was risk-adapted. Patients with low/intermediate risk received remission at 3 anthracycline-based consolidation courses, whereas high-risk patients received the same schedule as in the previous, non-risk-adapted AIDA-0493 trial including cytarabine. In addition, all patients in the AIDA-2000 received all-trans retinoic acid (ATRA) for 15 days during each consolidation. After induction, 600 of 636 (94.3%) and 420 of 445 (94.4%) patients achieved complete remission in the AIDA-0493 and AIDA-2000, respectively. The 6-year overall survival and cumulative incidence of relapse (CIR) rates were 78.1% versus 87.4% (P = .001) and 27.7% versus 10.7% (P < .0001). Significantly lower CIR rates for patients in the AIDA-2000 were most evident in the high-risk group (49.7% vs 9.3%, respectively, P < .0001). Our data confirm that anthracycline-based consolidation is at least equally effective as cytarabine-containing regimens for low-/intermediate-risk patients and suggest that a risk-adapted strategy including ATRA for consolidation improves outcome in newly diagnosed APL. Furthermore, our results highlight the role of cytarabine coupled to anthracyclines and ATRA during consolidation in the high-risk group.
2010
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/15 - MALATTIE DEL SANGUE
English
Con Impact Factor ISI
LO COCO, F., Avvisati, G., Vignetti, M., Breccia, M., Gallo, E., Rambaldi, A., et al. (2010). Front-line treatment of acute promyelocytic leukemia with AIDA induction followed by risk-adapted consolidation for adult patients younger than 61 years: results of the AIDA-2000 trial of the GIMEMA group. BLOOD, 116(17), 3171-3179 [10.1182/blood-2010-03-276196].
LO COCO, F; Avvisati, G; Vignetti, M; Breccia, M; Gallo, E; Rambaldi, A; Paoloni, F; Fioritoni, G; Ferrara, F; Specchia, G; Cimino, G; Diverio, D; Borlenghi, E; Martinelli, G; Di Raimondo, F; Di Bona, E; Fazi, P; Peta, A; Bosi, A; Carella, A; Fabbiano, F; Pogliani, E; Petti, M; Amadori, S; Mandelli, F
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/39976
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