Treatment of adult patients with acute promyelocytic leukemia according to the AIDA protocol


Cite item

Full Text

Abstract

AIM: To give the results of an investigation conducted at the Hematology Research Center (HRC), Ministry of Health of the Russian Federation (MHRF), to treat adult patients with acute promyelocytic leukemia (APL) according to the AIDA protocol elaborated by Spanish investigators/MATERIAL AND METHODS: The investigation enrolled 33 patients diagnosed with APL verified by cytogenetic and molecular studies, who had been treated at the HRC, MHRF, in July 2009 to January 2012. The patients classified in the low-, intermediate-, and high-risk groups were 30, 46.7; and 23.3%, respectively. The analysis was made in January 2013/RESULTS: The number of patients who achieved complete remission, as well as the mortality rates during remission induction were wholly comparable to those previously obtained when using the 7+3+ATRA protocol: 90.3 and 9.7%, respectively. One patient in remission died (3.6% mortality rate). The likelihood of recurrence in this investigation was high (21%), which was due to gross noncompliance with maintenance therapy. On examining the clearance of the malignant clone by FISH and polymerase chain reaction, a naturally chimeric transcript identified by a molecular study was statistically significantly more frequently revealed during postinduction therapy, which was associated with different sensitivity of the techniques. Comparison of changes in the disappearance of a chimeric marker for APL with the AIDA and 7+3+ARTA programs showed that the clearance of the malignant clone was much slower/CONCLUSION: The AIDA program is a highly effective treatment protocol for patients with APL.

About the authors

E N Parovichnikova

Гематологический научный центр Минздрава России, Москва

V V Troitskaia

Гематологический научный центр Минздрава России, Москва

A N Sokolov

Гематологический научный центр Минздрава России, Москва

G A Kliasova

Гематологический научный центр Минздрава России, Москва

G M Galstian

Гематологический научный центр Минздрава России, Москва

L A Kuz'mina

Гематологический научный центр Минздрава России, Москва

Email: Kuzlara@rambler.ru

E V Domracheva

Гематологический научный центр Минздрава России, Москва

V N Dvirnyk

Гематологический научный центр Минздрава России, Москва

V G Savchenko

Гематологический научный центр Минздрава России, Москва

References

  1. LoCoco F., Avvisati G., Orlando S.M. et al. ATRA and Arsenic Trioxide (ATO) Versus ATRA and Idarubicin (AIDA) for Newly Diagnosed, Non High-Risk Acute Promyelocytic Leukemia (APL): Results of the Phase III, Prospective, Randomized, Intergroup APL0406 Study by the Italian-German Cooperative Groups Gimema-SAL-AMLSG ASH 2012 abstr 6.
  2. Sanz M., Grimwade D., Tallmann M. et al. Management of acute promyelocytic leukemia recommendations from an expert panel on behalf of European LeukemiNet. Blood 2009; 113 (9): 1875-1891.
  3. Pei R., Cao J., Ma J. et al. Long term curative effects of sequential therapy with all-trans retinoic acid, arsenious oxide and chemotherapy on patients with acute promyelocytic leukemia. Hematology 2012; 17 (6): 311-316.
  4. Mathews V., George B., Chendamarai E. et al. Single-agent arsenic trioxide in the treatment of newly diagnosed acute promyelocytic leukemia: long-term follow-up data. JCO 2010; 28 (24): 3866-3871.
  5. Ghavamzadeh A., Alimoghaddam K., Ghaffari S.H. Treatment of acute promyelocytic leukemia with arsenic trioxide without ATRA and/or chemotherapy. Ann Oncol 2006; 17 (1): 131-134.
  6. Ravandi F. Effective treatment of acute promyelocytic leukemia with all-trans-retinoic acid, arsenic trioxide, and gemtuzumab ozogamicin. J Clin Oncol 2009; 27 (4): 504-510.
  7. Паровичникова Е.Н., Савченко В.Г., Исаев ВГ. и др. Итоги второго рандомизированного исследования Российской научно-исследовательской группы гематологических центров по лечению острых промиелоцитарных лейкозов. Гематол и трансфузиол 2007; 6: 3-9.
  8. Creutzig U., Zimmermann M., Dworzak М. et al. Favourable outcome of patients with childhood acute promyelocytic leukaemia after treatment with reduced cumulative anthracycline doses. Br J Haematol 2010; 149 (3): 399-409
  9. Sanz M.А., Montesinos P., Rayón C. et al. Risk-adapted treatment of acute promyelocytic leukemia based on all-trans retinoic acid and anthracycline with addition of cytarabine consolidation therapy for high-risk patients: further improvements in treatment outcome. Blood 2010; 115: 5137-5146.
  10. Sanz M.A., Grimwade D., Tallman M.S. et al. Management of acute promyelocytic leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet. Blood 2009; 113: 1875-1891.
  11. Montesinos P., Bergua J.M., Vellenga E. et al. Differentiation syndrome in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline chemotherapy: characteristics, outcome, and prognostic factors. Blood 2009; 113 (4): 775-783.
  12. Паровичникова Е.Н., Клясова Г.А., Соколов А.Н. и др. Первые результаты лечения острых миелоидных лейкозов взрослых по протоколу ОМЛ-01.10 Научно-исследовательской группы гематологических центров России. Тер арх 2012; 7: 10-15.
  13. Торопова И.Ю., Паровичникова Е.Н., Клясова Г.А. и др. Частота развития и структура инфекционных осложнений, возникающих у больных гемобластозами на различных этапах программной химиотерапии. Гематол и переливание крови 2012; 3: 141-152.
  14. Adès L., Sanz M.A., Chevret S. et al. Treatment of newly diagnosed acute promyelocytic leukemia (APL): a comparison of French-Belgian-Swiss and PETHEM/RESULTS: Blood 2008; 111 (3): 1078-1084.
  15. Burnett A.K., Hills R.K., Grimwade D. et al. Inclusion of chemotherapy in addition to anthracycline in the treatment of acute promyelocytic leukemia does not improve outcomes: results of the MRC-15 trial. Leukemia 2012 Dec 12. doi:1038leu.2012.360. Epub ahead of print
  16. Grimwade D., Jovanovic J.V., R.K. Hills. Prospective Minimal Residual Disease Monitoring to Predict Relapse of Acute Promyelocytic Leukemia and to Direct Pre-Emptive Arsenic Trioxide Therapy. J Clin Oncol 2009; 27 (22): 3650-3658.
  17. Савченко В.Г., Паровичникова Е.Н. Острый промиелоцитарный лейкоз. М: Литтерра 2010: 168-171.
  18. Grimwade D., LoCoco F. Acute promyelocytic leukemia: a model for the role of molecular diagnosis and residual disease monitoring in directing treatment approach in acute myeloid leukemia. Leukemia 2002; 16: 1959-1973.

Copyright (c) 2013 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies