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Acute Leukemia

Autologous transplant remains the preferred therapy for relapsed APL in CR2

Bone Marrow Transplantation volume 51, pages 1180–1183 (2016)Cite this article

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Abstract

Despite their favorable prognosis, 10–20% of acute promyelocytic leukemia (APL) patients relapse. Reinduction therapy is often followed by autologous hematopoietic cell transplantation (auto-HCT). Arsenic trioxide (ATO) has become part of standard reinduction and is often followed by auto-HCT. Data on patients in CR2 were collected from two large transplant registries (Center for International Blood and Marrow Transplant Research (CIBMTR) and European Group for Blood and Marrow Transplant (EBMT)) and two specialty referral centers. The outcome of patients in CR2 who received only ATO-based therapy as reinduction was retrospectively compared with those who got an auto-HCT, with or without ATO. Prognostic factors included age, disease risk, extramedullary disease and duration of CR1. Of 207 evaluable patients, the median age was 31.5 years, 15.3% had extramedullary disease and median WBC at diagnosis was 4.8 × 109/L. Sixty-seven patients received ATO alone and 140 underwent auto-HCT. The groups were comparable for age, gender, extramedullary disease, risk group and duration of CR1. At 5 years, overall survival (OS) was 42% and 78% for the ATO-only and auto-HCT groups, respectively (P<0.001). In addition, OS was associated with longer duration of CR1 (P=0.002), but not with disease risk at diagnosis. These data suggest that auto-HCT for APL patients in CR2 results in better OS than ATO-based therapy alone.

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Authors and Affiliations

  1. Department of Hematology, Shaare Zedek Medical Center, Jerusalem, Israel

    C Ganzel & J M Rowe

  2. Department of Hematology, Christian Medical College & Hospital, Vellore, India

    V Mathews

  3. Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran

    K Alimoghaddam & A Ghavamzadeh

  4. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    D Kuk & S Devlin

  5. Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA

    H Wang & M-J Zhang

  6. Bone Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis, MN, USA

    D Weisdorf

  7. Department of Medicine, Leukemia Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA

    D Douer & M S Tallman

  8. Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel

    J M Rowe

  9. Saint-Antoine Hospital and University Pierre & Marie Curie, Paris, France

    E Polge & M Mohty

  10. Acute Leukemia Working Party, EBMT Paris Study Office/CEREST-TC, Paris, France

    E Polge, A Nagler & M Mohty

  11. Hematology Department, Hospital Clinic, Institut d’investigacions Biomediques August Pi i Sunyer, Barcelona, Spain

    J Esteve

  12. Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel

    A Nagler

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  1. C Ganzel
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  7. H Wang
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  8. M-J Zhang
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  9. D Weisdorf
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  10. D Douer
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  14. A Nagler
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  15. M Mohty
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  16. M S Tallman
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Correspondence to C Ganzel.

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Ganzel, C., Mathews, V., Alimoghaddam, K. et al. Autologous transplant remains the preferred therapy for relapsed APL in CR2. Bone Marrow Transplant 51, 1180–1183 (2016). https://doi.org/10.1038/bmt.2016.96

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