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Incidence, risk factors, and outcomes of second neoplasms in patients with acute promyelocytic leukemia: the PETHEMA-PALG experience

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Autores de FISABIO

Autores ajenos a FISABIO

  • Sobas M
  • Knopinska-Posluszny W
  • Piatkowska-Jakubas B
  • García-Álvarez F
  • Díez MEA
  • Caballero M
  • Martínez-Cuadrón D
  • Aguiar E
  • González-Campos J
  • Garrido A
  • Algarra L
  • Salamero O
  • de la Serna J
  • Perez-Encinas MM
  • Vives S
  • Vidriales B
  • Labrador J
  • Prado AI
  • Celebrin L
  • Mayer J
  • Brioso J
  • de Laiglesia A
  • Bergua JM
  • Amigo ML
  • Rodriguez-Medina C
  • Polo M
  • Pluta A
  • Cichocka E
  • Skarupski M
  • Sanz MA
  • Wierzbowska A
  • Montesinos P

Grupos de Investigación

Abstract

The most important challenges in acute promyelocytic leukemia (APL) is preventing early death and reducing long-term events, such as second neoplasms (s-NPLs). We performed a retrospective analysis of 2670 unselected APL patients, treated with PETHEMA "chemotherapy based" and "chemotherapy free" protocols. Only de novo APL patients who achieved complete remission (CR) and completed the three consolidation cycles were enrolled into the analysis. Out of 2670 APL patients, there were 118 (4.4%) who developed s-NPLs with the median latency period (between first CR and diagnosis of s-NPL) of 48.0 months (range 2.8-231.1): 43.3 (range: 2.8-113.9) for s-MDS/AML and 61.7 (range: 7.1-231.1) for solid tumour. The 5-year CI of all s-NPLs was of 4.43% and 10 years of 7.92%. Among s-NPLs, there were 58 cases of s-MDS/AML, 3 cases of other hematological neoplasms, 57 solid tumours and 1 non-identified neoplasm. The most frequent solid tumour was colorectal, lung and breast cancer. Overall, the 2-year OS from diagnosis of s-NPLs was 40.6%, with a median OS of 11.1 months. Multivariate analysis identified age of 35 years (hazard ratio = 0.2584; p < 0.0001) as an independent prognostic factor for s-NPLs. There were no significant differences in CI of s-NPLs at 5 years between chemotherapy-based vs chemotherapy-free regimens (hazard ratio = 1.09; p = 0.932). Larger series with longer follow-up are required to confirm the potential impact of ATO+ATRA regimens to reduce the incidence of s-NPLs after front-line therapy for APL.

Datos de la publicación

ISSN/ISSNe:
0939-5555, 1432-0584

ANNALS OF HEMATOLOGY  SPRINGER

Tipo:
Article
Páginas:
451-461
PubMed:
38110588

Citas Recibidas en Web of Science: 3

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Keywords

  • Acute promyelocytic leukemia; Second neoplasms; Chemotherapy based and chemotherapy free regimens; Risk factors; Outcomes

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