Real-life Outcomes on Acute Promyelocytic Leukemia in Brazil - Early Deaths Are Still a Problem

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art_JR_Reallife_Outcomes_on_Acute_Promyelocytic_Leukemia_in_Brazil_2019.PDF (252.21 KB)
Citações na Scopus
17
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
CIG MEDIA GROUP, LP
Autores
Autor de Grupo de pesquisa
Citação
CLINICAL LYMPHOMA MYELOMA & LEUKEMIA, v.19, n.2, p.E116-E122, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Real-life outcomes in acute promyelocytic leukemia are apparently worse than those reported by prospective studies. Retrospective data on 61 adult patients were reviewed. An early death rate of 20% was found, with a 5-year overall survival estimated at 59%. The results of real-life studies differ from prospective trials. Early actions and supportive care are needed, aiming to decrease toxicity, especially in developing countries. Introduction: Although a considerable improvement in survival of patients with acute promyelocytic leukemia (APL) has been seen over the past decades, real-life outcomes seem to be worse than those reported by prospective studies. We aim to describe clinical characteristics and outcomes of adult patients diagnosed with APL in an academic hospital from the University of Sao Paulo. Patients and Methods: We retrospectively reviewed the medical charts of 61 patients with APL diagnosed between January 2007 and May 2017. Baseline clinical features and follow-up data were collected, focusing on early toxicity variables such as infection, bleeding, and thrombosis in the first 30 days from diagnosis. Results: Among the 61 patients with APL, 54 received any chemotherapy. All patients also received alltrans retinoic acid (ATRA). Bleeding events were the main cause of death before receiving chemotherapy. Most patients belonged to the intermediate (43%) and high-risk (41%) groups, according to Sanz score. The '7 + 3 + ATRA' regimen was the most used regimen (n = 38). An early death rate of 20% was found, predominantly owing to sepsis. After a median follow-up of 5 years, only 1 relapse was diagnosed. The overall survival at 5 years was 59%. Discussion: In comparison with prospective trials with ATRA-based regimens, we found an inferior overall survival, mostly on account of a high early-death rate. Our results are in line with other real-life retrospective reports published in the past decades. Conclusion: Results of real-life studies differ from those found by prospective trials. Accordingly, early actions and supportive care are still needed, aiming to decrease toxicity, especially in developing countries.
Palavras-chave
Acute Promyelocytic Leukemia, Bleeding, Clinical outcomes, Early death rate, Infection
URI
https://observatorio.fm.usp.br/handle/OPI/30798
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/11
Artigos e Materiais de Revistas Científicas - LIM/31
Artigos e Materiais de Revistas Científicas - ODS/03