PMID- 31874794
OWN - NLM
STAT- MEDLINE
DCOM- 20210512
LR  - 20210512
IS  - 2152-2669 (Electronic)
IS  - 2152-2669 (Linking)
VI  - 20
IP  - 2
DP  - 2020 Feb
TI  - Outcome of a Real-Life Population of Patients With Acute Promyelocytic Leukemia 
      Treated According to the PETHEMA Guidelines: The Polish Adult Leukemia Group 
      (PALG) Experience.
PG  - 105-113
LID - S2152-2650(19)32003-8 [pii]
LID - 10.1016/j.clml.2019.09.616 [doi]
AB  - BACKGROUND: Acute promyelocytic leukemia (APL) has a favorable prognosis. 
      However, results of randomized studies do not necessarily reflect the outcomes of 
      a real-life population. PATIENTS AND METHODS: We analyzed 283 unselected APL 
      patients treated in 20 Polish hospitals between 2005 and 2017. All patients were 
      intended to be treated with PETHEMA (Programa Espanol para el Tratamiento de las 
      Hemopatias Malignas) protocols based on all-trans retinoic acid plus 
      chemotherapy. RESULTS: The probability of overall survival at 4 years was 67%, 
      while event-free survival was 64%. The early death (ED) rate was 20.1% (n = 57), 
      while 3.5% (n = 10) patients died before induction therapy was started. The main 
      causes of ED included hemorrhage (45.6%), infections (17.5%), and differentiation 
      syndrome (14.5%). Of 273 treated patients, 214 (78.4%) experienced hematologic 
      morphologic remission, 2 (0.7%) were found to have resistant disease, 47 (17.2%) 
      could not be evaluated for response because of ED, and in 6 (3.7%) no data 
      concerning the response were available. Multivariate analyses showed that 
      predictors of ED and overall survival were Eastern Cooperative Oncology Group 
      performance status > 2, age > 60 years, and all types of bleeding episodes that 
      occurred before starting therapy, while an additional predictor of event-free 
      survival was high white blood cell count (> 10 10(9)/L). CONCLUSION: ED remains a 
      major problem in APL patients, especially in a real-life population. Shortening 
      of the time between the initial contact with a health care professional, and 
      all-trans retinoic acid administration and the use of appropriate supportive care 
      could improve the outcome of unselected APL population, mainly by reducing the ED 
      rate.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Sobas, Marta
AU  - Sobas M
AD  - Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, 
      Medical University, Wroclaw, Poland. Electronic address: marta.sobas@gmail.com.
FAU - Czyz, Anna
AU  - Czyz A
AD  - Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, 
      Medical University, Wroclaw, Poland.
FAU - Montesinos, Pau
AU  - Montesinos P
AD  - Department of Hematology, Hospital Universitario La Fe, Valencia, Spain; 
      CIBERONC, Instituto Carlos III, Madrid, Spain.
FAU - Armatys, Anna
AU  - Armatys A
AD  - Department of Hematology, Medical University of Silesia, Katowice, Poland.
FAU - Helbig, Grzegorz
AU  - Helbig G
AD  - Department of Hematology, Medical University of Silesia, Katowice, Poland.
FAU - Holowiecka, Aleksandra
AU  - Holowiecka A
AD  - Department of Hematology, Independent Public Central Clinical Hospital, Warsaw, 
      Poland.
FAU - Pluta, Agnieszka
AU  - Pluta A
AD  - Department of Hematology, Medical University, Lodz, Poland.
FAU - Zarzycka, Ewa
AU  - Zarzycka E
AD  - Department of Hematology, Medical University, Gdansk, Poland.
FAU - Piatkowska-Jakubas, Beata
AU  - Piatkowska-Jakubas B
AD  - Department of Hematology, Collegium Medicum, Jagiellonian University, Krakow, 
      Poland.
FAU - Majcherek, Maciej
AU  - Majcherek M
AD  - Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, 
      Medical University, Wroclaw, Poland.
FAU - Lewandowski, Krzysztof
AU  - Lewandowski K
AD  - Department of Hematology, University of Medical Sciences, Poznan, Poland.
FAU - Golos, Aleksandra
AU  - Golos A
AD  - Department of Hematology, Institute of Hematology, Warsaw, Poland.
FAU - Paluszewska, Monika
AU  - Paluszewska M
AD  - Department of Hematology, Medical University, Warsaw, Poland.
FAU - Podhorecka, Monika
AU  - Podhorecka M
AD  - Department of Hematology, Medical University, Lublin, Poland.
FAU - Oleksiuk, Jolanta
AU  - Oleksiuk J
AD  - Department of Hematology, Medical University, Bialystok, Poland.
FAU - Skret, Anna
AU  - Skret A
AD  - Department of Hematology, City Hospital, Rzeszow, Poland.
FAU - Hawrylecka, Dorota
AU  - Hawrylecka D
AD  - Department of Hematology, Hospital Brzozow, Brzozow, Poland.
FAU - Guzicka-Kazimierczak, Renata Ewa
AU  - Guzicka-Kazimierczak RE
AD  - Department of Hematology, Pomeranian Medical University, Szczecin, Poland.
FAU - Watek, Marzena
AU  - Watek M
AD  - Department of Hematology, Holy Cross Cancer Center, Kielce, Poland.
FAU - Gromek, Tomasz
AU  - Gromek T
AD  - Department of Hematology, Medical University, Lublin, Poland.
FAU - Charlinski, Grzegorz
AU  - Charlinski G
AD  - Department of Hematology, Nicolaus Copernicus Hospital, Torun, Poland.
FAU - Grosicki, Sebastian
AU  - Grosicki S
AD  - Department of Hematology, Medical University of Silesia, Katowice, Poland.
FAU - Holojda, Jadwiga
AU  - Holojda J
AD  - Department of Hematology, City Hospital, Legnica, Poland.
FAU - Miskiewicz, Wojciech
AU  - Miskiewicz W
AD  - Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, 
      Medical University, Wroclaw, Poland.
FAU - Martinez-Cuadron, David
AU  - Martinez-Cuadron D
AD  - Department of Hematology, Hospital Universitario La Fe, Valencia, Spain; 
      CIBERONC, Instituto Carlos III, Madrid, Spain.
FAU - Sanz, Miguel Angel
AU  - Sanz MA
AD  - Department of Hematology, Hospital Universitario La Fe, Valencia, Spain; 
      CIBERONC, Instituto Carlos III, Madrid, Spain.
FAU - Wrobel, Tomasz
AU  - Wrobel T
AD  - Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, 
      Medical University, Wroclaw, Poland.
FAU - Wierzbowska, Agnieszka
AU  - Wierzbowska A
AD  - Department of Hematology, Medical University, Lodz, Poland.
FAU - Giebel, Sebastian
AU  - Giebel S
AD  - Department of Hematology, Oncology Center, Gliwice Branch, Maria Sklodowska-Curie 
      Institute, Gliwice, Poland.
LA  - eng
PT  - Journal Article
DEP - 20190930
PL  - United States
TA  - Clin Lymphoma Myeloma Leuk
JT  - Clinical lymphoma, myeloma & leukemia
JID - 101525386
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Leukemia, Promyelocytic, Acute/*epidemiology/mortality
MH  - Male
MH  - Middle Aged
MH  - Poland
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - ATRA
OT  - Acute promyelocytic leukemia
OT  - Chemotherapy
OT  - Early death
OT  - Outcome
EDAT- 2019/12/26 06:00
MHDA- 2021/05/13 06:00
CRDT- 2019/12/26 06:00
PHST- 2019/05/14 00:00 [received]
PHST- 2019/08/14 00:00 [revised]
PHST- 2019/09/20 00:00 [accepted]
PHST- 2019/12/26 06:00 [pubmed]
PHST- 2021/05/13 06:00 [medline]
PHST- 2019/12/26 06:00 [entrez]
AID - S2152-2650(19)32003-8 [pii]
AID - 10.1016/j.clml.2019.09.616 [doi]
PST - ppublish
SO  - Clin Lymphoma Myeloma Leuk. 2020 Feb;20(2):105-113. doi: 
      10.1016/j.clml.2019.09.616. Epub 2019 Sep 30.