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Blood, 1 February 2008, Vol. 111, No. 3, pp. 1078-1084. Prepublished online as a Blood First Edition Paper on November 1, 2007; DOI 10.1182/blood-2007-07-099978. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2007-07-099978v1 111/3/1078    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Adès, L. Articles by Fenaux, P. Search for Related Content PubMed PubMed Citation Articles by Adès, L. Articles by Fenaux, P. Related Collections Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Treatment of newly diagnosed acute promyelocytic leukemia (APL): a comparison of French-Belgian-Swiss and PETHEMA results Lionel Adès1, Miguel A. Sanz2, Sylvie Chevret3, Pau Montesinos2, Patrice Chevallier4, Emmanuel Raffoux3, Edo Vellenga5, Agnès Guerci6, Arnaud Pigneux7, Francoise Huguet8, Consuelo Rayon9, Anne Marie Stoppa10, Javier de la Serna11, Jean-Yves Cahn12, Sandrine Meyer-Monard13, Thomas Pabst14, Xavier Thomas15, Stéphane de Botton16, Ricardo Parody17, Juan Bergua18, Thierry Lamy19, Anne Vekhoff20, Silvia Negri21, Norbert Ifrah22, Hervé Dombret3, Augustin Ferrant23, Dominique Bron24, Laurent Degos3, and Pierre Fenaux1 1 Hôpital Avicenne, Université Paris 13, Paris, France; 2 University Hospital La Fe, Valencia, Spain; 3 Hôpital Saint Louis, Université Paris 7, Paris, France; 4 Centre Hospitalier Universitaire (CHU) Nantes, Nantes, France; 5 University Hospital Groningen, Hanzeplein, the Netherlands; 6 CHU Nancy, Nancy, France; 7 CHU de Bordeaux, Bordeaux, France; 8 CHU de Toulouse, Toulouse, France; 9 Hospital Central de Asturias, Oviedo, Spain; 10 Institut Paoli Calmettes, Marseille, France; 11 Hospital 12 de Octubre, Madrid, Spain; 12 CHU Grenoble, Grenoble, France; 13 Universitatsspital Basel, Basel, Switzerland; 14 Universitatsspital Berne, Berne, Switzerland; 15 CHU Lyon, Lyon, France; 16 Institut gustave Roussy, Villejuif, France; 17 Hospital Virgen del Rocío, Sevilla, Spain; 18 Hospital San Pedro de Alcántara, Cáceres, Spain; 19 CHU Rennes, Rennes, France; 20 Hotel Dieu, Université Paris 5, Paris, France; 21 Hospital Carlos Haya, Málaga, Spain; 22 CHU Angers, Angers, France; 23 Université Catholique de Louvain, Brussels, Belgium; and 24 Institut Jules Bordet, Brussels, Belgium All-trans retinoic acid (ATRA) plus anthracycline chemotherapy is the reference treatment of newly diagnosed acute promyelocytic leukemia (APL), whereas the role of cytosine arabinoside (AraC) remains disputed. We performed a joint analysis of patients younger than 65 years included in Programa para el Estudio de la Terapéutica en Hemopatía Maligna (PETHEMA) LPA 99 trial, where patients received no AraC in addition to ATRA, high cumulative dose idarubicin, and mitoxantrone, and APL 2000 trial, where patients received AraC in addition to ATRA and lower cumulative dose daunorubicin. In patients with white blood cell (WBC) count less than 10 x 109/L, complete remission (CR) rates were similar, but 3-year cumulative incidence of relapse (CIR) was significantly lower in LPA 99 trial: 4.2% versus 14.3% (P = .03), although 3-year survival was similar in both trials. This suggested that AraC is not required in APL with WBC count less than 10 x 109/L, at least in trials with high-dose anthracycline and maintenance treatment. In patients with WBC of 10 x 109/L or more, however, the CR rate (95.1% vs 83.6% P = .018) and 3-year survival (91.5% vs 80.8%, P = .026) were significantly higher in APL 2000 trial, and there was a trend for lower 3-year CIR (9.9% vs 18.5%, P = .12), suggesting a beneficial role for AraC in those patients. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: C. Kelaidi, S. Chevret, S. De Botton, E. Raffoux, A. Guerci, X. Thomas, A. Pigneux, T. Lamy, F. Rigal-Huguet, S. Meyer-Monard, et al. Improved Outcome of Acute Promyelocytic Leukemia With High WBC Counts Over the Last 15 Years: The European APL Group Experience J. Clin. Oncol., June 1, 2009; 27(16): 2668 - 2676. [Abstract] [Full Text] [PDF] M. A. Sanz, D. Grimwade, M. S. Tallman, B. Lowenberg, P. Fenaux, E. H. Estey, T. Naoe, E. Lengfelder, T. Buchner, H. Dohner, et al. Management of acute promyelocytic leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet Blood, February 26, 2009; 113(9): 1875 - 1891. [Abstract] [Full Text] [PDF] C. Santamaria, M. C. Chillon, R. Garcia-Sanz, A. Balanzategui, M. E. Sarasquete, M. Alcoceba, F. Ramos, T. Bernal, J. A. Queizan, M. J. Penarrubia, et al. The relevance of preferentially expressed antigen of melanoma (PRAME) as a marker of disease activity and prognosis in acute promyelocytic leukemia Haematologica, December 1, 2008; 93(12): 1797 - 1805. [Abstract] [Full Text] [PDF] W.-Y. Au, S. Tam, B. M. Fong, and Y.-L. Kwong Determinants of cerebrospinal fluid arsenic concentration in patients with acute promyelocytic leukemia on oral arsenic trioxide therapy Blood, November 1, 2008; 112(9): 3587 - 3590. [Abstract] [Full Text] [PDF] M. Ono, T. Watanabe, C. Shimizu, N. Hiramoto, Y. Goto, K. Yonemori, T. Kouno, M. Ando, K. Tamura, N. Katsumata, et al. Therapy-Related Acute Promyelocytic Leukemia Caused by Hormonal Therapy and Radiation in a Patient with Recurrent Breast Cancer Jpn. J. Clin. Oncol., August 1, 2008; 38(8): 567 - 570. [Abstract] [Full Text] [PDF] M. S. Tallman and J. K. Altman Curative Strategies in Acute Promyelocytic Leukemia Hematology, January 1, 2008; 2008(1): 391 - 399. [Abstract] [Full Text] [PDF]

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