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Incidence, risk factors, and outcomes of second neoplasms in patients with acute promyelocytic leukemia: the PETHEMA-PALG experience.
Sobas, Marta; Knopinska-Posluszny, Wanda; Piatkowska-Jakubas, Beata; García-Álvarez, Flor; Díez, María Elena Amutio; Caballero, Mar; Martínez-Cuadrón, David; Aguiar, Eliana; González-Campos, Jose; Garrido, Ana; Algarra, Lorenzo; Salamero, Olga; de la Serna, Javier; Sayas, Maria Jose; Perez-Encinas, Manuel Mateo; Vives, Susana; Vidriales, Belén; Labrador, Jorge; Prado, Ana Inés; Celebrin, Lucía; Mayer, Jiri; Brioso, Joana; de Laiglesia, Almudena; Bergua, Juan Miguel; Amigo, Maria Luz; Rodriguez-Medina, Carlos; Polo, Marta; Pluta, Agnieszka; Cichocka, Edyta; Skarupski, Marek; Sanz, Miguel A; Wierzbowska, Agnieszka; Montesinos, Pau.
Afiliación
  • Sobas M; Department of Hematology, Blood Neoplasm and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland. marta.sobas@umw.edu.pl.
  • Knopinska-Posluszny W; Department of Hematology and Transplantology, Gdynia, Poland.
  • Piatkowska-Jakubas B; Collegium Medicum Jagiellonian University, Krakow, Poland.
  • García-Álvarez F; Hospital Central de Asturias, Oviedo, Spain.
  • Díez MEA; Hospital de Cruces, Barakaldo, Spain.
  • Caballero M; Hospital Insular de Las Palmas, Las Palmas de Gran Canaria, Spain.
  • Martínez-Cuadrón D; Hospital Universitario i Politècnico la Fe, Valencia, Spain.
  • Aguiar E; Centro Hospitalar Sao Joao, Porto, Portugal.
  • González-Campos J; Hospital U. Virgen del Rocio, Sevilla, Spain.
  • Garrido A; Hospital Sant Pau, Barcelona, Spain.
  • Algarra L; Hospital General de Albacete, Albacete, Spain.
  • Salamero O; Hospital U. Vall D'Hebron, Barcelona, Spain.
  • de la Serna J; Hospital 12 de Octubre, Madrid, Spain.
  • Sayas MJ; Hospital Dr. Peset, Valencia, Spain.
  • Perez-Encinas MM; University Hospital, Santiago de Compostela, Spain.
  • Vives S; Hospital U. Germans Trias i Pujol ICO, Badalona, Spain.
  • Vidriales B; University Hospital of Salamanca (CAUSA/IBSAL) and Center for Biomedical Research in Network of Cancer (CIBERONC), Salamanca, Spain.
  • Labrador J; Department of Hematology, Research Unit, Hospital Universitario de Burgos, Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain.
  • Prado AI; Hospital Maciel, Montevideo, Uruguay.
  • Celebrin L; Hospital Tornú, Buenos Aires, Argentina.
  • Mayer J; University Hospital Brno, Masaryk University, Brno, Czechia.
  • Brioso J; Hospital de Santa Maria, Lisboa, Portugal.
  • de Laiglesia A; Hospital Puerta de Hierro, Madrid, Spain.
  • Bergua JM; Hospital San Pedro de Alcántara, Caceres, Spain.
  • Amigo ML; Hospital Morales Meseguer, Murcia, Spain.
  • Rodriguez-Medina C; Hospital Universitario de Gran Canaria Doctor Negrin, Las Palmas de Gran Canaria, Spain.
  • Polo M; Hospital Clínico San Carlos, Madrid, Spain.
  • Pluta A; Medical University of Lodz, Lodz, Poland.
  • Cichocka E; Rydygiera Hospital, Torun, Poland.
  • Skarupski M; Faculty of Pure and Applied Mathematics, Wroclaw University of Science and Technology, Wroclaw, Poland.
  • Sanz MA; Department of Mathematics and Computer Science, Eindhoven University of Technology, 5612, AZ, Eindhoven, The Netherlands.
  • Wierzbowska A; Hospital Universitario i Politècnico la Fe, Valencia, Spain.
  • Montesinos P; Medical University of Lodz, Lodz, Poland.
Ann Hematol ; 103(2): 451-461, 2024 Feb.
Article en En | MEDLINE | ID: mdl-38110588
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Promielocítica Aguda / Neoplasias Primarias Secundarias Límite: Adult / Humans Idioma: En Revista: Ann Hematol Asunto de la revista: HEMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Promielocítica Aguda / Neoplasias Primarias Secundarias Límite: Adult / Humans Idioma: En Revista: Ann Hematol Asunto de la revista: HEMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Alemania