Acute promyelocytic leukemia (APL) in very old patients: real-life behind protocols.
Acute promyelocytic leukemia
all-trans retinoic acid
arsenic trioxide
elderly patients
real-life data
Journal
Acta oncologica (Stockholm, Sweden)
ISSN: 1651-226X
Titre abrégé: Acta Oncol
Pays: England
ID NLM: 8709065
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
pubmed:
1
9
2021
medline:
15
10
2021
entrez:
31
8
2021
Statut:
ppublish
Résumé
Acute promyelocytic leukemia (APL) is uncommon among subjects aged ≥ 70 years and the better therapeutic strategy represents an unmet clinical need. This prompted us to explore our real-life data on a retrospective cohort of 45 older APL patients (≥ 70 years) consecutively diagnosed at eight different hematologic institutions in Latium, Italy, from July 1991 to May 2019. Two patients (4.4%) died from early hemorrhagic complications before treatment could begin. Twenty-two patients (51.1%) (Group A) were enrolled or treated according to standard clinical protocols, while 21 (48.8%) (Group B) received an ATRA-based personalized approach due to poor performance status. Morphologic complete remission (CR) after induction therapy was achieved in 33 patients (76.7%) with 100% of patients in Group A and 52.3% in Group B ( The present analysis highlights that almost half of the patients received sub-optimal induction treatments and registered dismal outcomes demonstrating the importance of adopting standard therapies instead of modified or reduced personalized approaches also in the setting of frail older patients.
Sections du résumé
BACKGROUND
BACKGROUND
Acute promyelocytic leukemia (APL) is uncommon among subjects aged ≥ 70 years and the better therapeutic strategy represents an unmet clinical need.
MATERIALS AND METHODS
METHODS
This prompted us to explore our real-life data on a retrospective cohort of 45 older APL patients (≥ 70 years) consecutively diagnosed at eight different hematologic institutions in Latium, Italy, from July 1991 to May 2019.
RESULTS
RESULTS
Two patients (4.4%) died from early hemorrhagic complications before treatment could begin. Twenty-two patients (51.1%) (Group A) were enrolled or treated according to standard clinical protocols, while 21 (48.8%) (Group B) received an ATRA-based personalized approach due to poor performance status. Morphologic complete remission (CR) after induction therapy was achieved in 33 patients (76.7%) with 100% of patients in Group A and 52.3% in Group B (
CONCLUSIONS
CONCLUSIONS
The present analysis highlights that almost half of the patients received sub-optimal induction treatments and registered dismal outcomes demonstrating the importance of adopting standard therapies instead of modified or reduced personalized approaches also in the setting of frail older patients.
Identifiants
pubmed: 34461798
doi: 10.1080/0284186X.2021.1971291
doi:
Substances chimiques
Tretinoin
5688UTC01R
Arsenic Trioxide
S7V92P67HO
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM