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Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 25, No 18S (June 20 Supplement), 2007: 7069
© 2007 American Society of Clinical Oncology
Risk factors for early mortality, relapse and overall survival in new cases of APL treated by arsenic trioxide
K. Alimoghaddam,
A. Ghavamzadeh,
S. Rostami,
S. Ghaffari,
R. Hosseini,
B. Bahar,
E. Baybordi,
P. Radsafa,
M. Shadpoor,
E. Eini and
S. Abdolahi
Hematology Oncology BMT Research Ctr, Tehran, Iran (Islamic Republic of)
7069
Background: There are several known risk factors for APL treatment by ATRA and chemotherapy, but risk factors for new cases of APL treated by Arsenic Trioxide are unknown. Methods: Between May 2000 and September 2006, we treated 141 new cases of APL (Median age 28±12.8 y/o min=11, max=71) by 2 hours iv infusion of 0.15mg/kg ATO until complete remission. Trial approved by IRB and consent form obtained. Diagnosis was by clinical and morphologic characteristics and confirmed by cytogenetic and RT-PCR for detection of t(15,17) and presence of PML-RARa. After complete remission patients received consolidation by 28 days infusion of ATO for one or four courses. Known risk factors for APL treatment outcome (including PML-RARa isoforms, presence of MRD during follow up and WBC count at presentation analyzed for early mortality, relapse rate, DFS and OS. Results: Complete remission observed in 121 cases (85.8%) and early mortality rate was 14.9%. short isoform of detected in 36% of patients and 18% presented by WBC more than 10,000/µl. For early mortality, APL differentiation syndrome during treatment and WBC count more than 10,000/µl were risk factors. (P<0.001 and p=0.011 respectively) For DFS only predicting factor for relapse was detection of MRD (by nested PCR or by real time PCR) during follow up (P=0.05). For prediction of OS, again only risk factor was detection of MRD(P<0.0001). Conclusions: Although WBC count before treatment and APL differentiation syndrome during treatment are risk factor for relapse, short isoform of APL is not a risk factor. After achieving to CR only risk factor is detection of MRD.
No significant financial relationships to disclose.
Abstract presentation from the 2007 ASCO Annual Meeting
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