PMID- 36075113
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220924
IS  - 1936-5233 (Print)
IS  - 1936-5233 (Electronic)
IS  - 1936-5233 (Linking)
VI  - 25
DP  - 2022 Nov
TI  - Evolving of treatment paradigms and challenges in acute promyelocytic leukaemia: 
      A real-world analysis of 1105 patients over the last three decades.
PG  - 101522
LID - S1936-5233(22)00181-4 [pii]
LID - 10.1016/j.tranon.2022.101522 [doi]
LID - 101522
AB  - Although acute promyelocytic leukaemia (APL) is a highly curable disease, 
      challenges of early death (ED) and relapse still exist, and real-world data are 
      scarce in the ATRA plus ATO era. A total of 1105 APL patients from 1990 to 2020 
      were enrolled and categorized into three treatment periods, namely ATRA, ATRA 
      plus ATO, and risk-adapted therapy. The early death (ED) rate was 20.2%, 10.1%, 
      and 7.0%, respectively, in three periods, while there was no significant decline 
      in the 7-day death rate. Consistently, the overall survival (OS) and disease-free 
      survival (DFS) of APL patients markedly improved over time. Despite the last two 
      periods exhibiting similar DFS, the chemotherapy load was substantially lower in 
      Period 3. Notably, leveraging older age and higher WBC count (especially > 
      50 x 10(9)/L), we could identify a small group of extremely high-risk patients 
      who had a very high ED rate and poor prognosis, while those with NRAS mutations 
      and higher WBC tended to relapse, both representing obstacles to curing all 
      patients. In conclusion, the evolvement of treatment paradigms can reduce the ED 
      rate, improve clinical outcomes, and spare patients the toxicity of chemotherapy. 
      Special care and innovative agents are warranted for the particularly high-risk 
      APL.
CI  - Copyright (c) 2022. Published by Elsevier Inc.
FAU - Teng-Fei, Sun
AU  - Teng-Fei S
AD  - Shanghai Institute of Haematology, State Key Laboratory of Medical Genomics, 
      National Research Centre for Translational Medicine at Shanghai, Ruijin Hospital 
      Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
FAU - Diyaer, Abuduaini
AU  - Diyaer A
AD  - Shanghai Institute of Haematology, State Key Laboratory of Medical Genomics, 
      National Research Centre for Translational Medicine at Shanghai, Ruijin Hospital 
      Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
FAU - Hong-Ming, Zhu
AU  - Hong-Ming Z
AD  - Shanghai Institute of Haematology, State Key Laboratory of Medical Genomics, 
      National Research Centre for Translational Medicine at Shanghai, Ruijin Hospital 
      Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
FAU - Xin-Jie, Chen
AU  - Xin-Jie C
AD  - Shanghai Institute of Haematology, State Key Laboratory of Medical Genomics, 
      National Research Centre for Translational Medicine at Shanghai, Ruijin Hospital 
      Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
FAU - Wen-Fang, Wang
AU  - Wen-Fang W
AD  - Shanghai Institute of Haematology, State Key Laboratory of Medical Genomics, 
      National Research Centre for Translational Medicine at Shanghai, Ruijin Hospital 
      Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
FAU - Yu-Bing, Zhao
AU  - Yu-Bing Z
AD  - Shanghai Institute of Haematology, State Key Laboratory of Medical Genomics, 
      National Research Centre for Translational Medicine at Shanghai, Ruijin Hospital 
      Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
FAU - Xiao-Jing, Lin
AU  - Xiao-Jing L
AD  - Shanghai Institute of Haematology, State Key Laboratory of Medical Genomics, 
      National Research Centre for Translational Medicine at Shanghai, Ruijin Hospital 
      Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 
      Electronic address: me5537@126.com.
FAU - Wen-Yan, Cheng
AU  - Wen-Yan C
AD  - Shanghai Institute of Haematology, State Key Laboratory of Medical Genomics, 
      National Research Centre for Translational Medicine at Shanghai, Ruijin Hospital 
      Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 
      Electronic address: cheng_wenyan@126.com.
FAU - Yang, Shen
AU  - Yang S
AD  - Shanghai Institute of Haematology, State Key Laboratory of Medical Genomics, 
      National Research Centre for Translational Medicine at Shanghai, Ruijin Hospital 
      Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 
      Electronic address: yang_shen@sjtu.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20220905
PL  - United States
TA  - Transl Oncol
JT  - Translational oncology
JID - 101472619
PMC - PMC9465437
OTO - NOTNLM
OT  - Acute promyelocytic leukaemia
OT  - Chemotherapy
OT  - Early death
OT  - Survival
COIS- Declaration of Competing Interest All authors declare no competing interest.
EDAT- 2022/09/09 06:00
MHDA- 2022/09/09 06:01
PMCR- 2022/09/05
CRDT- 2022/09/08 18:12
PHST- 2022/06/22 00:00 [received]
PHST- 2022/08/06 00:00 [revised]
PHST- 2022/08/12 00:00 [accepted]
PHST- 2022/09/09 06:00 [pubmed]
PHST- 2022/09/09 06:01 [medline]
PHST- 2022/09/08 18:12 [entrez]
PHST- 2022/09/05 00:00 [pmc-release]
AID - S1936-5233(22)00181-4 [pii]
AID - 101522 [pii]
AID - 10.1016/j.tranon.2022.101522 [doi]
PST - ppublish
SO  - Transl Oncol. 2022 Nov;25:101522. doi: 10.1016/j.tranon.2022.101522. Epub 2022 
      Sep 5.