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Late first relapses in APL treated with all-trans-retinoic acid- and anthracycline- based chemotherapy: the European APL group experience (APL 91 and APL 93 trials)

Leukemia volume 20, pages 905–907 (2006)Cite this article

The routine use of frontline all-trans retinoic acid (ATRA) and anthracycline-based chemotherapy has greatly improved the outcome of APL, particularly by reducing the incidence of relapses, notably early relapses. Overall, the combination of ATRA and anthracycline-based chemotherapy yields complete remission rates greater than 90% in newly diagnosed APL.1, 2 With maintenance combining continuous 6-mercaptopurine (6MP) and methotrexate (MTX) to intermittent ATRA and possibly with early introduction of chemotherapy during induction treatment, the relapse risk in APL has now been reduced to 10–15%.1, 2, 3, 4

Before the ATRA era, the large majority of first relapses in APL occurred within 3 years of CR achievement, and only 2–3% of the patients relapsed after 4 years.5, 6 Theoretically, the possibility exists that the addition of ATRA to chemotherapy in newly diagnosed APL may only delay some of the relapses that were seen earlier with chemotherapy alone. The incidence and characteristics of late relapses occurring after ATRA- and anthracycline-based chemotherapy, however, are not known.

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References

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Acknowledgements

This work was supported by the Programme Hospitalier de Recherche Clinique (CHU Lille), the Association de Recherche Contre le Cancer and the Ligue Nationale Contre le Cancer (Comité du Nord).

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Author notes

  1. C Kelaidi and L Ades: These authors contributed equally as first authors to this work.

Authors and Affiliations

  1. Hôpital Avicenne, Paris, France

    C Kelaidi, L Ades & P Fenaux

  2. Hôpital Saint-Louis, Paris, France

    S Chevret, E Raffoux, H Dombret & L Degos

  3. Hospital La Fe, Valencia, Spain

    M Sanz

  4. CHU Nancy, Nancy, France

    A Guerci

  5. CHU Lyon, Lyon, France

    X Thomas

  6. CHU Lille, Lille, France

    S de Botton

  7. CHU Montpellier, Montpellier, France

    C Rayon

  8. CHU Limoges, Limoges, France

    N Fegueux

  9. CHU Toulouse, Toulouse, France

    D Bordessoule

  10. IPC Marseille, Marseille, France

    F Rigal-Huguet

  11. Hanover Medical School,, Ontario, Canada

    H Link

  12. Hospital Asturias, Oviedo, Spain

    A Stoppa

  13. Hôpital Hôtel-Dieu, Paris, France

    A Vekhoff

  14. Inselspital, Bern, Switzerland

    S Meyer-Monard

  15. CHU Versailles, Versailles, France

    S Castaigne

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  1. C Kelaidi
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  16. S Castaigne
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  17. H Dombret
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  18. L Degos
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  19. P Fenaux
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on behalf of the French APL group

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Correspondence to P Fenaux.

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Kelaidi, C., Ades, L., Chevret, S. et al. Late first relapses in APL treated with all-trans-retinoic acid- and anthracycline- based chemotherapy: the European APL group experience (APL 91 and APL 93 trials). Leukemia 20, 905–907 (2006). https://doi.org/10.1038/sj.leu.2404158

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