Relapse in acute promyelocytic leukemia and the role of hematopoietic stem cell transplantation in the treatment of APL
Authors:
P. Žák 1; Z. Kořístek 2
Authors‘ workplace:
II. interní klinika – oddělení klinické hematologie, Lékařská fakulta v Hradci Králové, Univerzita Karlova v Praze, přednosta prof. MUDr. Jaroslav Malý, CSc.
1; Interní hematoonkologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jiří Vorlíček, CSc.
2
Published in:
Vnitř Lék 2008; 54(7-8): 751-756
Category:
Review
Overview
The authors focused on relapses and transplantation treatment in APL. The incidence of relapses, their risk factors, and extramedullary relapses are reviewed. Considering treatment of relapses in APL, arsenic trioxide is now the standard treatment of APL relapse, however, treatment with gentuzumab ozogamicin should be considered when only a molecular relapse is detected. The following part of the issue is focused on the current status of hematopoietic stem cell transplantation in APL and on indications of transplantations from a modern APL therapy point of view.
Key words:
acute promyelocytic leukemia – relapse – extramedullary relapse – hematopoietic stem cell transplantation – arsenic trioxide – gentuzumab ozogamicin
Sources
1. Sanz MA, Martín G, Rayón C et al. A modified AIDA protocol with anthracycline‑based consolidation results in high antileukemic eficacy and reduced toxicity in newly diagnosed PML/RARα-positive acute promyelocytic leukemia. PETHEMA group. Blood 1999; 94: 3015–3021.
2. Sanz MA, Martín G, Gonzáles M et al. Risk-adapted treatment of acute promyelocytic leukemia with all‑trans‑retinoic acid and anthracycline monochemotherapy: a multicenter study by the PETHEMA group. Blood 2004; 103: 1237–1243.
3. Adés L, Chevret S, Raffoux E et al. Is cytarabine useful in the treatment of acute promyelocytic leukemia? Results of a randomized trial from the European Acute Promyelocytic Leukemia Group. J Clin Oncol 2006; 24: 5703–5710.
4. Fenaux P, Chastang C, Chevret S et al. A randomized comparison of all transretinoic acid (ATRA) followed by chemotherapy and ATRA plus chemotherapy and the role of maintenance therapy in newly diagnosed acute promyelocytic leukemia. The European APL Group. Blood 1999; 94: 1192–1200.
5. Frankel SR, Eardley A, Heller G et al. All‑trans retinoic acid for acute promyelocytic leukemia. Results of the New York study. Ann Intern Med 1994; 120: 278–286.
6. Tallman MS, Andersen JW, Schiffer CA et al. All‑trans‑retinoic acid in acute promyelocytic leukemia. N Engl J Med 1997; 337: 1021–1028.
7. Tallman MS, Andersen JW, Schiffer CA et al. All‑trans retinoic acid in acute promyelocytic leukemia: long‑term outcome and prognostic factor analysis from the North American Intergroup protocol. Blood 2002; 100: 4298–4302.
8. Sanz M, Lo Coco F, Martin G et al. Definition of relapse risk and role of nonanthracycline drugs for consolidation in patients with acute promyelocytic leukemia: a joint study of the PETHEMA and the GIMEMA cooperative groups. Blood 2000; 96: 1247–1253.
9. Adés L, Sanz M, Chevret et al. Treatment of newly diagnosed acute promyelocytic leukemia (APL): a comparison of French-Belgian-Swiss and PETHEMA results. Blood 2008; 111: 1078–1084.
10. Specchia G, Lo Coco F, Vignetti M et al. Extramedullary involvement at relapse in acute promyelocytic leukemia patients treated or not with all‑trans retinoic acid: A report by the Gruppo Italiano Malattie Ematologiche dell’Adulto. J Clin Oncol 2001; 19: 4023–4028.
11. de Botton S, Sanz M, Chevret S et al. Extramedullary relapse in acute promyelocytic leukaemia treated with all‑trans retinoic acid and chemotherapy. Leukemia 2006; 20: 35–41.
12. Lunghi M, Castagnola C, Calatroni S et al. Central nervous system relapse in acute promyelocytic leukaemia. Haematologica 2006; 91: ECR24.
13. Evans GD, Grimwade DJ. Extramedullary disease in acute promyelocytic leukemia. Leuk Lymphoma 1999; 33: 219–229.
14. Soignet SL. Clinical experience of arsenic trioxide in relapsed acute promyelocytic leukemia. Oncologist 2001; 6: 11–16.
15. Shen ZX, Chen GQ, Ni JH et al. Use of arsenic trioxide (As2O3) in the treatment of acute promyelocytic leukemia (APL): II. Clinical efficacy and pharmacokinetics in relapsed patients. Blood 1997; 89: 3354–3360.
16. Sun HD, Ma L, Hu XC et al. Ai‑lin 1 treated 32 cases of acute promyelocytic leukemia. Chin J Integrat Chin Wes Med 1992; 12: 170–172.
17. Soignet SL, Maslak P, Wang ZG et al. Complete remission after treatment of acute promyelocytic leukemia with arsenic trioxide. N Engl J Med 1998; 339: 1341–1348.
18. Soignet SL, Frankel S, Tallman M et al. Arsenic trioxide (ATO) in relapsed acute promyelocytic leukemia (APL): the combined results and follow‑up from the U.S. pilot and multicenter trials. Blood 2000; 96: 827a.
19. Thomas X, Dombret H, Cordonnier C et al. Treatment of relapsing acute promyelocytic leukemia by all‑trans retinoic acid therapy followed by time sequential chemotherapy and stem cell transplantation. APL Study Group. Acute promyelocytic leukemia. Leukemia 2000; 14: 1006–1013.
20. Jurcic JG, De Blasio T, Dumont L et al. Molecular remission induction with retinoic acid and anti‑CD33 monoclonal antibody HuM195 in acute promyeloctic leukemia. Clin Cancer Res 2000; 6: 372–380.
21. Petti MC, Pinazzi MB, Diverio D et al. Prolonged molecular remission in advanced acute promyelocytic leukemia after treatment with gentuzumab ozogamicin (Mylotarg CMA-676). Br J Haematol 2001; 115: 63–65.
22. Francesco Lo-Coco F, Cimino G, Breccia M et al. Gemtuzumab ozogamicin (Mylotarg) as a single agent for molecularly relapsed acute promyelocytic leukemia. Blood 2004; 104: 1995–1999.
23. Zhang P, Wang SY, Hu XH et al. Arsenic trioxide-treated 72 cases of acute promyelocytic leukemia. Chin J Hematol 1996; 17: 170–171.
24. Niu C, Yan H, Yu T et al. Studies on Treatment of Acute Promyelocytic Leukemia With Arsenic Trioxide: Remission Induction, Follow‑Up, and Molecular Monitoring in 11 Newly Diagnosed and 47 Relapsed Acute Promyelocytic Leukemia Patients. Blood 1999; 94: 3315–3324.
25. Soignet SL, Frankel SR, Douer D et al. United States multicenter study of arsenic trioxide in relapsed acute promyelocytic leukemia. J Clin Oncol 2001; 19: 3852–3860.
26. Shen Y, Shen ZX, Yan H et al. Studies on the clinical efficacy and pharmacokinetics of low‑dose arsenic trioxide in the treatment of relapsed acute promyelocytic leukemia: A comparison with conventional dosage. Leukemia 2001; 15: 735–741.
27. Mandelli F, Labopin M, Granena A et al. European survey of bone marrow transplantation in acute promyelocytic leukemia (M3). Working Party on Acute Leukemia of the European Cooperative Group for Bone Marrow Transplantation (EBMT). Bone Marrow Transplant 1994; 14: 293–298.
28. Burnett AK, Goldstone AH, Stevens RM et al. Randomized comparison of addition of autologous bone-marrow transplantation to intensive chemotherapy for acute myeloid leukemia in first remission: results of MRC AML 10 trial. Lancet 1998; 351: 700–708.
29. Meloni G, Diverio D, Vignetti M et al. Autologous Bone Marrow Transplantation for Acute Promyelocytic Leukemia in Second Remission: Prognostic Relevance of Pretransplant Minimal Residual Disease Assessment by Reverse-Transcription Polymerase Chain Reaction of the PML/RARα Fusion Gene. Blood 1997; 90: 1321–1325.
30. Nabhan C, Mehta J, Tallman MS. The role of bone marrow transplantation in acute promyelocytic leukemia. Bone Marrow Transplant 2001; 28: 219–226.
31. Roman J, Martin C, Torres A et al. Absence of detectable PML‑RARα fusion transcript in long‑term remission patients after BMT for acute promyelocytic leukemia. Bone Marrow Transplant 1997; 19: 679–683.
32. Diverio D, Rossi V, Avvisati G et al Early detection of relapse by prospective reverse transcriptase-polymerase chain reaction analysis of the PML/RARα fusion gene in patients with acute promyelocytic leukemie enrolled in the GINEMA-AIEOP multicenter AIDA trial. Blood 1998; 92: 784–789.
33. Sanz MA, Rubia J, Bonanad S et al. Prolonged molecular remission after PML/RARα-positive autologous peripheral blood stem cell transplantation in acute promyelocytic leukemia: is relevant pretransplant minimal residual disease in the graft? Leukemia 1998; 12: 992–995.
34. Lo-Coco F, Romano A, Mengarelli A et al. Allogeneic stem cell transplantation for advanced acute promyelocytic leukemia: results in patients treated in second molecular remission or with molecularly persistent disease. Leukemia 2003; 17: 1930–1933.
35. Sanz MA, Arcese W, Rubia J et al. Stem cell transplantation (SCT) for acute promyelocytic leukemia in ATRA era: A survey of the European Blood and Marrow Transplantation Group (EBMT). Blood 2000; 96: 522a (Abstract 2247).
36. Tallman MS, Nabhan Ch, Feusner JH et al. Acute promyelocytic leukemia: evolving therapeutic strategies. Blood 2002; 99: 759–767.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2008 Issue 7-8
Most read in this issue
- An urgency in hematology: acute promyelocytic leukemia – principles of diagnosis
- Coagulopathy and differentiation syndrome: the main complications of the initial treatment of acute promyelocytic leukemia
- Brief case reports illustrate various initial courses in acute promyelocytic leukemia
- Leukemogenesis and therapy of acute promyelocytic leukemia: from the worse to the most favorable subtype of acute myeloid leukemia