Treatment of acute promyelocytic leukemia with PETHEMA LPA 99 protocol: a Tunisian single center experience

Acute promyelocytic leukemia (APL) has now become the most curable of all subtypes of acute myeloid leukemia. A cure rate of 75-80% can be anticipated with a combination of all-trans retinoic acid (ATRA) and anthracyclines. In Tunisia, the ATRA era began in 1998 with the use, consecutively, of two r...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Hematology 2010-08, Vol.15 (4), p.204-209
Hauptverfasser: Jeddi, Ramzi, Ghédira, Héla, Menif, Samia, Ben Neji, Hend, Ben Amor, Ramzi, Kacem, Karima, Aissaoui, Lamia, Bouteraâ, Walid, Abdennebi, Yosr, Raihane, Ben Lakhal, Gouider, Emna, Raouf, Hafsia, Hèla, Ben Abid, Saad, Ali, Zaher, Belhadjali, Meddeb, Balkis
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 209
container_issue 4
container_start_page 204
container_title Hematology
container_volume 15
creator Jeddi, Ramzi
Ghédira, Héla
Menif, Samia
Ben Neji, Hend
Ben Amor, Ramzi
Kacem, Karima
Aissaoui, Lamia
Bouteraâ, Walid
Abdennebi, Yosr
Raihane, Ben Lakhal
Gouider, Emna
Raouf, Hafsia
Hèla, Ben Abid
Saad, Ali
Zaher, Belhadjali
Meddeb, Balkis
description Acute promyelocytic leukemia (APL) has now become the most curable of all subtypes of acute myeloid leukemia. A cure rate of 75-80% can be anticipated with a combination of all-trans retinoic acid (ATRA) and anthracyclines. In Tunisia, the ATRA era began in 1998 with the use, consecutively, of two regimens of a combination of ATRA with anthracycline and cytarabine (APL93), and without cytarabine (LPA99). From 2004, 39 patients with confirmed APL either by t(15;17) or PML/RARA were treated by the PETHEMA LPA 99 trial. The rationale of this protocol by avoiding cytarabine is to reduce death in complete remission (CR) without increasing the incidence of relapse. Thirty-three patients achieved CR (84·6%). The remaining six patients were considered as failure due to early death: three caused by differentiation syndrome (DS) and three died from central nervous system hemorrhage. Baseline blood cell count (WBC) >10 × 10 9 /l (P=0·26) and creatinine >1·4 mg/dl (P=0·42) were not predictive of mortality. DS was observed in 11 patients (30·5%) with a median onset time of 12 days (range: 3-23 days) and median WBC of 29 × 10 9 /L (range: 1·2 × 10 9 -82·7 × 10 9 /l). DS was severe in seven cases, moderate in four, and fatal in three cases. Body mass index ≥30 (P=0·044) and baseline WBC ≥20 × 10 9 /l (P=0·025) are independent predictors of DS. The median follow-up of this study is 36 months. Thirty patients are alive in continuous complete remission; two patients died in CR from septic shock and secondary myelodysplastic syndrome respectively; one patient died 47 months after achieving two relapses. Event free survival from diagnosis was 80% and overall survival was 82%. Our results are quite acceptable and can be improved by reducing mortality rate.
doi_str_mv 10.1179/102453309X12583347114176
format Article
fullrecord <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_pasteur_00646569v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>749019524</sourcerecordid><originalsourceid>FETCH-LOGICAL-c412t-75a28684992f64c82dce30187b832237ba6d2e4fe9bf47c979c5f5049bdbf1773</originalsourceid><addsrcrecordid>eNqFkU9v1DAUxC0EoqXwFZBvnAL-FzvmtlotbKVF9LBI3CzHeaamTrzYTst--6baUnFBnN4cfjOjp0EIU_KeUqU_UMJEyznR3ylrO86FolRQJZ-hcyqJajrRiud_6TP0qpSfhDBGFHmJzhiRigjVnaObfQZbR5gqTh5bN1fAh5zGI8TkjjU4HGG-gTFYfBfqNb7a7LebLyu8u1phrR_QmlyKH7HF-3kKJdgJlzD9iIDdEgoZw-8D5ACTg9fohbexwJvHe4G-fdrs19tm9_Xz5Xq1a5ygrDaqtayTndCaeSlcxwYHnNBO9R1njKveyoGB8KB7L5TTSrvWt0Tofug9VYpfoOaUe22jOeQw2nw0yQazXe3MwZYKczaESCFbqW_pwr878cs3v2Yo1YyhOIjRTpDmYpTQhOqWiYXsTqTLqZQM_imeEvOwjPnXMov17WPJ3I8wPBn_TLEA6xMQJp_yaO9SjoOp9hhT9tlOLhTD_1tzD1zMnPk</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>749019524</pqid></control><display><type>article</type><title>Treatment of acute promyelocytic leukemia with PETHEMA LPA 99 protocol: a Tunisian single center experience</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Jeddi, Ramzi ; Ghédira, Héla ; Menif, Samia ; Ben Neji, Hend ; Ben Amor, Ramzi ; Kacem, Karima ; Aissaoui, Lamia ; Bouteraâ, Walid ; Abdennebi, Yosr ; Raihane, Ben Lakhal ; Gouider, Emna ; Raouf, Hafsia ; Hèla, Ben Abid ; Saad, Ali ; Zaher, Belhadjali ; Meddeb, Balkis</creator><creatorcontrib>Jeddi, Ramzi ; Ghédira, Héla ; Menif, Samia ; Ben Neji, Hend ; Ben Amor, Ramzi ; Kacem, Karima ; Aissaoui, Lamia ; Bouteraâ, Walid ; Abdennebi, Yosr ; Raihane, Ben Lakhal ; Gouider, Emna ; Raouf, Hafsia ; Hèla, Ben Abid ; Saad, Ali ; Zaher, Belhadjali ; Meddeb, Balkis</creatorcontrib><description>Acute promyelocytic leukemia (APL) has now become the most curable of all subtypes of acute myeloid leukemia. A cure rate of 75-80% can be anticipated with a combination of all-trans retinoic acid (ATRA) and anthracyclines. In Tunisia, the ATRA era began in 1998 with the use, consecutively, of two regimens of a combination of ATRA with anthracycline and cytarabine (APL93), and without cytarabine (LPA99). From 2004, 39 patients with confirmed APL either by t(15;17) or PML/RARA were treated by the PETHEMA LPA 99 trial. The rationale of this protocol by avoiding cytarabine is to reduce death in complete remission (CR) without increasing the incidence of relapse. Thirty-three patients achieved CR (84·6%). The remaining six patients were considered as failure due to early death: three caused by differentiation syndrome (DS) and three died from central nervous system hemorrhage. Baseline blood cell count (WBC) &gt;10 × 10 9 /l (P=0·26) and creatinine &gt;1·4 mg/dl (P=0·42) were not predictive of mortality. DS was observed in 11 patients (30·5%) with a median onset time of 12 days (range: 3-23 days) and median WBC of 29 × 10 9 /L (range: 1·2 × 10 9 -82·7 × 10 9 /l). DS was severe in seven cases, moderate in four, and fatal in three cases. Body mass index ≥30 (P=0·044) and baseline WBC ≥20 × 10 9 /l (P=0·025) are independent predictors of DS. The median follow-up of this study is 36 months. Thirty patients are alive in continuous complete remission; two patients died in CR from septic shock and secondary myelodysplastic syndrome respectively; one patient died 47 months after achieving two relapses. Event free survival from diagnosis was 80% and overall survival was 82%. Our results are quite acceptable and can be improved by reducing mortality rate.</description><identifier>ISSN: 1607-8454</identifier><identifier>ISSN: 1024-5332</identifier><identifier>EISSN: 1607-8454</identifier><identifier>EISSN: 1520-4383</identifier><identifier>DOI: 10.1179/102453309X12583347114176</identifier><identifier>PMID: 20670478</identifier><language>eng</language><publisher>England: Taylor &amp; Francis</publisher><subject>Adolescent ; Adult ; Aged ; Antineoplastic Agents ; Antineoplastic Agents - adverse effects ; Antineoplastic Agents - therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; APL ; ATRA ; Body Mass Index ; CHEMOTHERAPY ; Child ; Child, Preschool ; Creatinine ; Creatinine - blood ; DIFFERENTIATION SYNDROME ; Female ; Hematology ; Human health and pathology ; Humans ; Idarubicin ; Idarubicin - adverse effects ; Idarubicin - therapeutic use ; Leukemia, Promyelocytic, Acute ; Leukemia, Promyelocytic, Acute - blood ; Leukemia, Promyelocytic, Acute - complications ; Leukemia, Promyelocytic, Acute - drug therapy ; Leukocyte Count ; Life Sciences ; Male ; Middle Aged ; Paraneoplastic Syndromes ; Paraneoplastic Syndromes - chemically induced ; Risk Factors ; Severity of Illness Index ; Survival Analysis ; Tretinoin ; Tretinoin - adverse effects ; Tretinoin - therapeutic use ; Tunisia ; Tunisia - epidemiology ; Young Adult</subject><ispartof>Hematology, 2010-08, Vol.15 (4), p.204-209</ispartof><rights>2010 Maney Publishing 2010</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c412t-75a28684992f64c82dce30187b832237ba6d2e4fe9bf47c979c5f5049bdbf1773</citedby><cites>FETCH-LOGICAL-c412t-75a28684992f64c82dce30187b832237ba6d2e4fe9bf47c979c5f5049bdbf1773</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20670478$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://riip.hal.science/pasteur-00646569$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Jeddi, Ramzi</creatorcontrib><creatorcontrib>Ghédira, Héla</creatorcontrib><creatorcontrib>Menif, Samia</creatorcontrib><creatorcontrib>Ben Neji, Hend</creatorcontrib><creatorcontrib>Ben Amor, Ramzi</creatorcontrib><creatorcontrib>Kacem, Karima</creatorcontrib><creatorcontrib>Aissaoui, Lamia</creatorcontrib><creatorcontrib>Bouteraâ, Walid</creatorcontrib><creatorcontrib>Abdennebi, Yosr</creatorcontrib><creatorcontrib>Raihane, Ben Lakhal</creatorcontrib><creatorcontrib>Gouider, Emna</creatorcontrib><creatorcontrib>Raouf, Hafsia</creatorcontrib><creatorcontrib>Hèla, Ben Abid</creatorcontrib><creatorcontrib>Saad, Ali</creatorcontrib><creatorcontrib>Zaher, Belhadjali</creatorcontrib><creatorcontrib>Meddeb, Balkis</creatorcontrib><title>Treatment of acute promyelocytic leukemia with PETHEMA LPA 99 protocol: a Tunisian single center experience</title><title>Hematology</title><addtitle>Hematology</addtitle><description>Acute promyelocytic leukemia (APL) has now become the most curable of all subtypes of acute myeloid leukemia. A cure rate of 75-80% can be anticipated with a combination of all-trans retinoic acid (ATRA) and anthracyclines. In Tunisia, the ATRA era began in 1998 with the use, consecutively, of two regimens of a combination of ATRA with anthracycline and cytarabine (APL93), and without cytarabine (LPA99). From 2004, 39 patients with confirmed APL either by t(15;17) or PML/RARA were treated by the PETHEMA LPA 99 trial. The rationale of this protocol by avoiding cytarabine is to reduce death in complete remission (CR) without increasing the incidence of relapse. Thirty-three patients achieved CR (84·6%). The remaining six patients were considered as failure due to early death: three caused by differentiation syndrome (DS) and three died from central nervous system hemorrhage. Baseline blood cell count (WBC) &gt;10 × 10 9 /l (P=0·26) and creatinine &gt;1·4 mg/dl (P=0·42) were not predictive of mortality. DS was observed in 11 patients (30·5%) with a median onset time of 12 days (range: 3-23 days) and median WBC of 29 × 10 9 /L (range: 1·2 × 10 9 -82·7 × 10 9 /l). DS was severe in seven cases, moderate in four, and fatal in three cases. Body mass index ≥30 (P=0·044) and baseline WBC ≥20 × 10 9 /l (P=0·025) are independent predictors of DS. The median follow-up of this study is 36 months. Thirty patients are alive in continuous complete remission; two patients died in CR from septic shock and secondary myelodysplastic syndrome respectively; one patient died 47 months after achieving two relapses. Event free survival from diagnosis was 80% and overall survival was 82%. Our results are quite acceptable and can be improved by reducing mortality rate.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Agents</subject><subject>Antineoplastic Agents - adverse effects</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Antineoplastic Combined Chemotherapy Protocols</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>APL</subject><subject>ATRA</subject><subject>Body Mass Index</subject><subject>CHEMOTHERAPY</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Creatinine</subject><subject>Creatinine - blood</subject><subject>DIFFERENTIATION SYNDROME</subject><subject>Female</subject><subject>Hematology</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Idarubicin</subject><subject>Idarubicin - adverse effects</subject><subject>Idarubicin - therapeutic use</subject><subject>Leukemia, Promyelocytic, Acute</subject><subject>Leukemia, Promyelocytic, Acute - blood</subject><subject>Leukemia, Promyelocytic, Acute - complications</subject><subject>Leukemia, Promyelocytic, Acute - drug therapy</subject><subject>Leukocyte Count</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Paraneoplastic Syndromes</subject><subject>Paraneoplastic Syndromes - chemically induced</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Survival Analysis</subject><subject>Tretinoin</subject><subject>Tretinoin - adverse effects</subject><subject>Tretinoin - therapeutic use</subject><subject>Tunisia</subject><subject>Tunisia - epidemiology</subject><subject>Young Adult</subject><issn>1607-8454</issn><issn>1024-5332</issn><issn>1607-8454</issn><issn>1520-4383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU9v1DAUxC0EoqXwFZBvnAL-FzvmtlotbKVF9LBI3CzHeaamTrzYTst--6baUnFBnN4cfjOjp0EIU_KeUqU_UMJEyznR3ylrO86FolRQJZ-hcyqJajrRiud_6TP0qpSfhDBGFHmJzhiRigjVnaObfQZbR5gqTh5bN1fAh5zGI8TkjjU4HGG-gTFYfBfqNb7a7LebLyu8u1phrR_QmlyKH7HF-3kKJdgJlzD9iIDdEgoZw-8D5ACTg9fohbexwJvHe4G-fdrs19tm9_Xz5Xq1a5ygrDaqtayTndCaeSlcxwYHnNBO9R1njKveyoGB8KB7L5TTSrvWt0Tofug9VYpfoOaUe22jOeQw2nw0yQazXe3MwZYKczaESCFbqW_pwr878cs3v2Yo1YyhOIjRTpDmYpTQhOqWiYXsTqTLqZQM_imeEvOwjPnXMov17WPJ3I8wPBn_TLEA6xMQJp_yaO9SjoOp9hhT9tlOLhTD_1tzD1zMnPk</recordid><startdate>20100801</startdate><enddate>20100801</enddate><creator>Jeddi, Ramzi</creator><creator>Ghédira, Héla</creator><creator>Menif, Samia</creator><creator>Ben Neji, Hend</creator><creator>Ben Amor, Ramzi</creator><creator>Kacem, Karima</creator><creator>Aissaoui, Lamia</creator><creator>Bouteraâ, Walid</creator><creator>Abdennebi, Yosr</creator><creator>Raihane, Ben Lakhal</creator><creator>Gouider, Emna</creator><creator>Raouf, Hafsia</creator><creator>Hèla, Ben Abid</creator><creator>Saad, Ali</creator><creator>Zaher, Belhadjali</creator><creator>Meddeb, Balkis</creator><general>Taylor &amp; Francis</general><general>Maney Publishing</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope></search><sort><creationdate>20100801</creationdate><title>Treatment of acute promyelocytic leukemia with PETHEMA LPA 99 protocol: a Tunisian single center experience</title><author>Jeddi, Ramzi ; Ghédira, Héla ; Menif, Samia ; Ben Neji, Hend ; Ben Amor, Ramzi ; Kacem, Karima ; Aissaoui, Lamia ; Bouteraâ, Walid ; Abdennebi, Yosr ; Raihane, Ben Lakhal ; Gouider, Emna ; Raouf, Hafsia ; Hèla, Ben Abid ; Saad, Ali ; Zaher, Belhadjali ; Meddeb, Balkis</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c412t-75a28684992f64c82dce30187b832237ba6d2e4fe9bf47c979c5f5049bdbf1773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Agents</topic><topic>Antineoplastic Agents - adverse effects</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Antineoplastic Combined Chemotherapy Protocols</topic><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>APL</topic><topic>ATRA</topic><topic>Body Mass Index</topic><topic>CHEMOTHERAPY</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Creatinine</topic><topic>Creatinine - blood</topic><topic>DIFFERENTIATION SYNDROME</topic><topic>Female</topic><topic>Hematology</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Idarubicin</topic><topic>Idarubicin - adverse effects</topic><topic>Idarubicin - therapeutic use</topic><topic>Leukemia, Promyelocytic, Acute</topic><topic>Leukemia, Promyelocytic, Acute - blood</topic><topic>Leukemia, Promyelocytic, Acute - complications</topic><topic>Leukemia, Promyelocytic, Acute - drug therapy</topic><topic>Leukocyte Count</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Paraneoplastic Syndromes</topic><topic>Paraneoplastic Syndromes - chemically induced</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Survival Analysis</topic><topic>Tretinoin</topic><topic>Tretinoin - adverse effects</topic><topic>Tretinoin - therapeutic use</topic><topic>Tunisia</topic><topic>Tunisia - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jeddi, Ramzi</creatorcontrib><creatorcontrib>Ghédira, Héla</creatorcontrib><creatorcontrib>Menif, Samia</creatorcontrib><creatorcontrib>Ben Neji, Hend</creatorcontrib><creatorcontrib>Ben Amor, Ramzi</creatorcontrib><creatorcontrib>Kacem, Karima</creatorcontrib><creatorcontrib>Aissaoui, Lamia</creatorcontrib><creatorcontrib>Bouteraâ, Walid</creatorcontrib><creatorcontrib>Abdennebi, Yosr</creatorcontrib><creatorcontrib>Raihane, Ben Lakhal</creatorcontrib><creatorcontrib>Gouider, Emna</creatorcontrib><creatorcontrib>Raouf, Hafsia</creatorcontrib><creatorcontrib>Hèla, Ben Abid</creatorcontrib><creatorcontrib>Saad, Ali</creatorcontrib><creatorcontrib>Zaher, Belhadjali</creatorcontrib><creatorcontrib>Meddeb, Balkis</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>Hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jeddi, Ramzi</au><au>Ghédira, Héla</au><au>Menif, Samia</au><au>Ben Neji, Hend</au><au>Ben Amor, Ramzi</au><au>Kacem, Karima</au><au>Aissaoui, Lamia</au><au>Bouteraâ, Walid</au><au>Abdennebi, Yosr</au><au>Raihane, Ben Lakhal</au><au>Gouider, Emna</au><au>Raouf, Hafsia</au><au>Hèla, Ben Abid</au><au>Saad, Ali</au><au>Zaher, Belhadjali</au><au>Meddeb, Balkis</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of acute promyelocytic leukemia with PETHEMA LPA 99 protocol: a Tunisian single center experience</atitle><jtitle>Hematology</jtitle><addtitle>Hematology</addtitle><date>2010-08-01</date><risdate>2010</risdate><volume>15</volume><issue>4</issue><spage>204</spage><epage>209</epage><pages>204-209</pages><issn>1607-8454</issn><issn>1024-5332</issn><eissn>1607-8454</eissn><eissn>1520-4383</eissn><abstract>Acute promyelocytic leukemia (APL) has now become the most curable of all subtypes of acute myeloid leukemia. A cure rate of 75-80% can be anticipated with a combination of all-trans retinoic acid (ATRA) and anthracyclines. In Tunisia, the ATRA era began in 1998 with the use, consecutively, of two regimens of a combination of ATRA with anthracycline and cytarabine (APL93), and without cytarabine (LPA99). From 2004, 39 patients with confirmed APL either by t(15;17) or PML/RARA were treated by the PETHEMA LPA 99 trial. The rationale of this protocol by avoiding cytarabine is to reduce death in complete remission (CR) without increasing the incidence of relapse. Thirty-three patients achieved CR (84·6%). The remaining six patients were considered as failure due to early death: three caused by differentiation syndrome (DS) and three died from central nervous system hemorrhage. Baseline blood cell count (WBC) &gt;10 × 10 9 /l (P=0·26) and creatinine &gt;1·4 mg/dl (P=0·42) were not predictive of mortality. DS was observed in 11 patients (30·5%) with a median onset time of 12 days (range: 3-23 days) and median WBC of 29 × 10 9 /L (range: 1·2 × 10 9 -82·7 × 10 9 /l). DS was severe in seven cases, moderate in four, and fatal in three cases. Body mass index ≥30 (P=0·044) and baseline WBC ≥20 × 10 9 /l (P=0·025) are independent predictors of DS. The median follow-up of this study is 36 months. Thirty patients are alive in continuous complete remission; two patients died in CR from septic shock and secondary myelodysplastic syndrome respectively; one patient died 47 months after achieving two relapses. Event free survival from diagnosis was 80% and overall survival was 82%. Our results are quite acceptable and can be improved by reducing mortality rate.</abstract><cop>England</cop><pub>Taylor &amp; Francis</pub><pmid>20670478</pmid><doi>10.1179/102453309X12583347114176</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1607-8454
ispartof Hematology, 2010-08, Vol.15 (4), p.204-209
issn 1607-8454
1024-5332
1607-8454
1520-4383
language eng
recordid cdi_hal_primary_oai_HAL_pasteur_00646569v1
source MEDLINE; EZB-FREE-00999 freely available EZB journals
subjects Adolescent
Adult
Aged
Antineoplastic Agents
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Antineoplastic Combined Chemotherapy Protocols
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
APL
ATRA
Body Mass Index
CHEMOTHERAPY
Child
Child, Preschool
Creatinine
Creatinine - blood
DIFFERENTIATION SYNDROME
Female
Hematology
Human health and pathology
Humans
Idarubicin
Idarubicin - adverse effects
Idarubicin - therapeutic use
Leukemia, Promyelocytic, Acute
Leukemia, Promyelocytic, Acute - blood
Leukemia, Promyelocytic, Acute - complications
Leukemia, Promyelocytic, Acute - drug therapy
Leukocyte Count
Life Sciences
Male
Middle Aged
Paraneoplastic Syndromes
Paraneoplastic Syndromes - chemically induced
Risk Factors
Severity of Illness Index
Survival Analysis
Tretinoin
Tretinoin - adverse effects
Tretinoin - therapeutic use
Tunisia
Tunisia - epidemiology
Young Adult
title Treatment of acute promyelocytic leukemia with PETHEMA LPA 99 protocol: a Tunisian single center experience
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T04%3A08%3A58IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_hal_p&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Treatment%20of%20acute%20promyelocytic%20leukemia%20with%20PETHEMA%20LPA%2099%20protocol:%20a%20Tunisian%20single%20center%20experience&rft.jtitle=Hematology&rft.au=Jeddi,%20Ramzi&rft.date=2010-08-01&rft.volume=15&rft.issue=4&rft.spage=204&rft.epage=209&rft.pages=204-209&rft.issn=1607-8454&rft.eissn=1607-8454&rft_id=info:doi/10.1179/102453309X12583347114176&rft_dat=%3Cproquest_hal_p%3E749019524%3C/proquest_hal_p%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=749019524&rft_id=info:pmid/20670478&rfr_iscdi=true