Outcomes in patients with relapsed or refractory acute promyelocytic leukemia treated with or without autologous or allogeneic hematopoietic stem cell transplantation

Naveen Pemmaraju; Maria Florencia Tanaka; Farhad Ravandi; Heather Lin; Veerabhadran Baladandayuthapani; Gabriela Rondon; Sergio A. Giralt; Julianne Chen; Sherry Pierce; Jorge Cortes; Hagop Kantarjian; Richard E. Champlin; Marcos De Lima; Muzaffar H. Qazilbash

doi:10.1016/j.clml.2013.02.023

Outcomes in patients with relapsed or refractory acute promyelocytic leukemia treated with or without autologous or allogeneic hematopoietic stem cell transplantation

Naveen Pemmaraju
, Maria Florencia Tanaka
, Farhad Ravandi
, Heather Lin
, Veerabhadran Baladandayuthapani
, Gabriela Rondon
, Sergio A. Giralt
, Julianne Chen
, Sherry Pierce
, Jorge Cortes
, Hagop Kantarjian
, Richard E. Champlin
, Marcos De Lima
, Muzaffar H. Qazilbash

Research output: Contribution to journal › Article › peer-review

28 Scopus citations

Abstract

Background: Outcomes in patients with acute promyelocytic leukemia (APL) have improved; however, a significant number of patients still relapse despite receiving all-trans-retinoic acid (ATRA) and arsenic-based therapies. Patients and Methods: Outcomes of patients with relapsed APL who were treated at our institution (1980-2010) and who received HCT were compared with those who received chemotherapy (CT) only. Results: Among 40 patients, 24 received HCT (autologous [auto] HCT, 7; allogeneic [allo] HCT, 14; both, 3); 16 received CT only. The median age at diagnosis was 36 years (range, 13-50 years), 31 years (range, 16-58 years), and 44 years (range, 24-79 years) for the auto-HCT, allo-HCT, and CT groups, respectively. Ten (100%) patients who received auto-HCT and 12 (71%) who received allo-HCT were in complete remission at the time of the HCT. The median follow-ups in the auto-HCT, allo-HCT, and CT groups were 74 months (range, 26-135 months), 118 months (range, 28-284 months), and 122 months (range, 32-216 months), respectively. Transplantation-related mortality (1 year) after auto-HCT and allo-HCT were 10% and 29%, respectively. The 7-year event-free survival after auto-HCT and allo-HCT was 68.6% and 40.6%, respectively (P =.45). The 7-year overall survival was 85.7%, 49.4%, and 40% in the auto-HCT, allo-HCT, and CT groups, respectively (P =.48). Conclusion: Both auto-HCT and allo-HCT are associated with durable remission and prolonged survival. All 3 strategies (auto-HCT, allo-HCT, CT) were found to be feasible in the relapsed APL setting and result in long-term disease control in selected patients. In this retrospective analysis, overall survival for patients who received HCT was not significantly better than patients who received CT only, but a trend toward better outcomes was seen in patients who underwent auto-HCT, although not statistically significant.

Original language	English (US)
Pages (from-to)	485-492
Number of pages	8
Journal	Clinical Lymphoma, Myeloma and Leukemia
Volume	13
Issue number	4
DOIs	https://doi.org/10.1016/j.clml.2013.02.023
State	Published - Aug 2013
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Acute myeloid leukemia
Acute promyelocytic leukemia
Allogeneic transplantation
Autologous transplantation
Bone marrow transplantation
Stem cell transplantation

ASJC Scopus subject areas

Hematology
Oncology
Cancer Research

Access to Document

10.1016/j.clml.2013.02.023

Cite this

Pemmaraju, N., Tanaka, M. F., Ravandi, F., Lin, H., Baladandayuthapani, V., Rondon, G., Giralt, S. A., Chen, J., Pierce, S., Cortes, J., Kantarjian, H., Champlin, R. E., De Lima, M., & Qazilbash, M. H. (2013). Outcomes in patients with relapsed or refractory acute promyelocytic leukemia treated with or without autologous or allogeneic hematopoietic stem cell transplantation. Clinical Lymphoma, Myeloma and Leukemia, 13(4), 485-492. https://doi.org/10.1016/j.clml.2013.02.023

Outcomes in patients with relapsed or refractory acute promyelocytic leukemia treated with or without autologous or allogeneic hematopoietic stem cell transplantation. / Pemmaraju, Naveen; Tanaka, Maria Florencia; Ravandi, Farhad et al.
In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 13, No. 4, 08.2013, p. 485-492.

Research output: Contribution to journal › Article › peer-review

Pemmaraju, N, Tanaka, MF, Ravandi, F, Lin, H, Baladandayuthapani, V, Rondon, G, Giralt, SA, Chen, J, Pierce, S, Cortes, J, Kantarjian, H, Champlin, RE, De Lima, M & Qazilbash, MH 2013, 'Outcomes in patients with relapsed or refractory acute promyelocytic leukemia treated with or without autologous or allogeneic hematopoietic stem cell transplantation', Clinical Lymphoma, Myeloma and Leukemia, vol. 13, no. 4, pp. 485-492. https://doi.org/10.1016/j.clml.2013.02.023

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title = "Outcomes in patients with relapsed or refractory acute promyelocytic leukemia treated with or without autologous or allogeneic hematopoietic stem cell transplantation",

abstract = "Background: Outcomes in patients with acute promyelocytic leukemia (APL) have improved; however, a significant number of patients still relapse despite receiving all-trans-retinoic acid (ATRA) and arsenic-based therapies. Patients and Methods: Outcomes of patients with relapsed APL who were treated at our institution (1980-2010) and who received HCT were compared with those who received chemotherapy (CT) only. Results: Among 40 patients, 24 received HCT (autologous [auto] HCT, 7; allogeneic [allo] HCT, 14; both, 3); 16 received CT only. The median age at diagnosis was 36 years (range, 13-50 years), 31 years (range, 16-58 years), and 44 years (range, 24-79 years) for the auto-HCT, allo-HCT, and CT groups, respectively. Ten (100\%) patients who received auto-HCT and 12 (71\%) who received allo-HCT were in complete remission at the time of the HCT. The median follow-ups in the auto-HCT, allo-HCT, and CT groups were 74 months (range, 26-135 months), 118 months (range, 28-284 months), and 122 months (range, 32-216 months), respectively. Transplantation-related mortality (1 year) after auto-HCT and allo-HCT were 10\% and 29\%, respectively. The 7-year event-free survival after auto-HCT and allo-HCT was 68.6\% and 40.6\%, respectively (P =.45). The 7-year overall survival was 85.7\%, 49.4\%, and 40\% in the auto-HCT, allo-HCT, and CT groups, respectively (P =.48). Conclusion: Both auto-HCT and allo-HCT are associated with durable remission and prolonged survival. All 3 strategies (auto-HCT, allo-HCT, CT) were found to be feasible in the relapsed APL setting and result in long-term disease control in selected patients. In this retrospective analysis, overall survival for patients who received HCT was not significantly better than patients who received CT only, but a trend toward better outcomes was seen in patients who underwent auto-HCT, although not statistically significant.",

keywords = "Acute myeloid leukemia, Acute promyelocytic leukemia, Allogeneic transplantation, Autologous transplantation, Bone marrow transplantation, Stem cell transplantation",

author = "Naveen Pemmaraju and Tanaka, \{Maria Florencia\} and Farhad Ravandi and Heather Lin and Veerabhadran Baladandayuthapani and Gabriela Rondon and Giralt, \{Sergio A.\} and Julianne Chen and Sherry Pierce and Jorge Cortes and Hagop Kantarjian and Champlin, \{Richard E.\} and \{De Lima\}, Marcos and Qazilbash, \{Muzaffar H.\}",

year = "2013",

month = aug,

doi = "10.1016/j.clml.2013.02.023",

language = "English (US)",

volume = "13",

pages = "485--492",

journal = "Clinical Lymphoma, Myeloma and Leukemia",

issn = "2152-2650",

publisher = "Elsevier Inc.",

number = "4",

}

TY - JOUR

T1 - Outcomes in patients with relapsed or refractory acute promyelocytic leukemia treated with or without autologous or allogeneic hematopoietic stem cell transplantation

AU - Pemmaraju, Naveen

AU - Tanaka, Maria Florencia

AU - Ravandi, Farhad

AU - Lin, Heather

AU - Baladandayuthapani, Veerabhadran

AU - Rondon, Gabriela

AU - Giralt, Sergio A.

AU - Chen, Julianne

AU - Pierce, Sherry

AU - Cortes, Jorge

AU - Kantarjian, Hagop

AU - Champlin, Richard E.

AU - De Lima, Marcos

AU - Qazilbash, Muzaffar H.

PY - 2013/8

Y1 - 2013/8

N2 - Background: Outcomes in patients with acute promyelocytic leukemia (APL) have improved; however, a significant number of patients still relapse despite receiving all-trans-retinoic acid (ATRA) and arsenic-based therapies. Patients and Methods: Outcomes of patients with relapsed APL who were treated at our institution (1980-2010) and who received HCT were compared with those who received chemotherapy (CT) only. Results: Among 40 patients, 24 received HCT (autologous [auto] HCT, 7; allogeneic [allo] HCT, 14; both, 3); 16 received CT only. The median age at diagnosis was 36 years (range, 13-50 years), 31 years (range, 16-58 years), and 44 years (range, 24-79 years) for the auto-HCT, allo-HCT, and CT groups, respectively. Ten (100%) patients who received auto-HCT and 12 (71%) who received allo-HCT were in complete remission at the time of the HCT. The median follow-ups in the auto-HCT, allo-HCT, and CT groups were 74 months (range, 26-135 months), 118 months (range, 28-284 months), and 122 months (range, 32-216 months), respectively. Transplantation-related mortality (1 year) after auto-HCT and allo-HCT were 10% and 29%, respectively. The 7-year event-free survival after auto-HCT and allo-HCT was 68.6% and 40.6%, respectively (P =.45). The 7-year overall survival was 85.7%, 49.4%, and 40% in the auto-HCT, allo-HCT, and CT groups, respectively (P =.48). Conclusion: Both auto-HCT and allo-HCT are associated with durable remission and prolonged survival. All 3 strategies (auto-HCT, allo-HCT, CT) were found to be feasible in the relapsed APL setting and result in long-term disease control in selected patients. In this retrospective analysis, overall survival for patients who received HCT was not significantly better than patients who received CT only, but a trend toward better outcomes was seen in patients who underwent auto-HCT, although not statistically significant.

AB - Background: Outcomes in patients with acute promyelocytic leukemia (APL) have improved; however, a significant number of patients still relapse despite receiving all-trans-retinoic acid (ATRA) and arsenic-based therapies. Patients and Methods: Outcomes of patients with relapsed APL who were treated at our institution (1980-2010) and who received HCT were compared with those who received chemotherapy (CT) only. Results: Among 40 patients, 24 received HCT (autologous [auto] HCT, 7; allogeneic [allo] HCT, 14; both, 3); 16 received CT only. The median age at diagnosis was 36 years (range, 13-50 years), 31 years (range, 16-58 years), and 44 years (range, 24-79 years) for the auto-HCT, allo-HCT, and CT groups, respectively. Ten (100%) patients who received auto-HCT and 12 (71%) who received allo-HCT were in complete remission at the time of the HCT. The median follow-ups in the auto-HCT, allo-HCT, and CT groups were 74 months (range, 26-135 months), 118 months (range, 28-284 months), and 122 months (range, 32-216 months), respectively. Transplantation-related mortality (1 year) after auto-HCT and allo-HCT were 10% and 29%, respectively. The 7-year event-free survival after auto-HCT and allo-HCT was 68.6% and 40.6%, respectively (P =.45). The 7-year overall survival was 85.7%, 49.4%, and 40% in the auto-HCT, allo-HCT, and CT groups, respectively (P =.48). Conclusion: Both auto-HCT and allo-HCT are associated with durable remission and prolonged survival. All 3 strategies (auto-HCT, allo-HCT, CT) were found to be feasible in the relapsed APL setting and result in long-term disease control in selected patients. In this retrospective analysis, overall survival for patients who received HCT was not significantly better than patients who received CT only, but a trend toward better outcomes was seen in patients who underwent auto-HCT, although not statistically significant.

KW - Acute myeloid leukemia

KW - Acute promyelocytic leukemia

KW - Allogeneic transplantation

KW - Autologous transplantation

KW - Bone marrow transplantation

KW - Stem cell transplantation

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UR - https://www.scopus.com/pages/publications/84880759655#tab=citedBy

U2 - 10.1016/j.clml.2013.02.023

DO - 10.1016/j.clml.2013.02.023

M3 - Article

C2 - 23769669

AN - SCOPUS:84880759655

SN - 2152-2650

VL - 13

SP - 485

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JO - Clinical Lymphoma, Myeloma and Leukemia

JF - Clinical Lymphoma, Myeloma and Leukemia

IS - 4

ER -

Outcomes in patients with relapsed or refractory acute promyelocytic leukemia treated with or without autologous or allogeneic hematopoietic stem cell transplantation

Abstract

UN SDGs

Keywords

ASJC Scopus subject areas

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