Your browser doesn't support javascript.
loading
Clinical networking results in continuous improvement of the outcome of patients with acute promyelocytic leukemia.
Koury, Luísa Corrêa de Araújo; Kim, Haesook T; Undurraga, Maria Soledad; Navarro-Cabrera, Juan Ramon; Salinas, Victor; Muxi, Pablo; Melo, Raul A M; Glória, Ana Beatriz; Pagnano, Katia; Nunes, Elenaide C; Bittencourt, Rosane I; Rojas, Ninoska; Quintana, Shirley; Ayala-Lugo, Ana; Oliver, Ana Carolina; Figueiredo-Pontes, Lorena; Traina, Fabiola; Moreira, Frederico; Fagundes, Evandro M; Duarte, Bruno K L; Mora-Alferez, Analí Pamela; Ortiz, Percy; Untama, Jose; Tallman, Martin; Ribeiro, Raul; Ganser, Arnold; Dillon, Richard; Valk, Peter J M; Sanz, Miguel; Löwenberg, Bob; Berliner, Nancy; Rego, Eduardo M.
Afiliación
  • Koury LCA; Department of Medical Imaging, Hematology, and Oncology, Medical School of Ribeirão Preto, University of São Paulo, and Center for Cell Therapy, Fundação Hemocentro, Ribeirão Preto, Brazil.
  • Kim HT; Department of Data Science, Dana-Farber Cancer Institute, Boston, MA.
  • Undurraga MS; Department of Hematology, Hospital del Salvador, Santiago, Chile.
  • Navarro-Cabrera JR; Department of Hematology, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Perú.
  • Salinas V; Instituto de Previsión Social, Asunción, Paraguay.
  • Muxi P; Hematology Division, Hospital Britanico, Montevideo, Uruguay.
  • Melo RAM; Department of Internal Medicine, Faculdade de Ciências Médicas, University of Pernambuco, Recife, Brazil.
  • Glória AB; Hematology Division, Federal University of Minas Gerais, Belo Horizonte, Brazil.
  • Pagnano K; Hematology and Hemotherapy Center, Centro de Hematologia e Hemoterapia, University of Campinas, Campinas, Brazil.
  • Nunes EC; Hematology Division, Federal University of Paraná, Curitiba, Brazil.
  • Bittencourt RI; Hematology Division, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
  • Rojas N; Department of Hematology, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Perú.
  • Quintana S; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.
  • Ayala-Lugo A; Department of Molecular Genetics, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Asunción, Paraguay.
  • Oliver AC; Hematology Division, Hospital Britanico, Montevideo, Uruguay.
  • Figueiredo-Pontes L; Department of Medical Imaging, Hematology, and Oncology, Medical School of Ribeirão Preto, University of São Paulo, and Center for Cell Therapy, Fundação Hemocentro, Ribeirão Preto, Brazil.
  • Traina F; Department of Medical Imaging, Hematology, and Oncology, Medical School of Ribeirão Preto, University of São Paulo, and Center for Cell Therapy, Fundação Hemocentro, Ribeirão Preto, Brazil.
  • Moreira F; Laboratory of Medical Investigation in Pathogenesis and Target-Therapy in Onco-Immuno-Hematology, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.
  • Fagundes EM; Hematology Division, Federal University of Minas Gerais, Belo Horizonte, Brazil.
  • Duarte BKL; Hematology and Hemotherapy Center, Centro de Hematologia e Hemoterapia, University of Campinas, Campinas, Brazil.
  • Mora-Alferez AP; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.
  • Ortiz P; Department of Hematology, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Perú.
  • Untama J; Department of Hematology, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Perú.
  • Tallman M; Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Ribeiro R; Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN.
  • Ganser A; Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.
  • Dillon R; Department of Medical and Molecular Genetics, King's College London School of Medicine, London, United Kingdom.
  • Valk PJM; Department of Hematology, Erasmus MC Cancer Institute and Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • Sanz M; Department of Hematology, Valencia University Medical School, Valencia, Spain.
  • Löwenberg B; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain.
  • Berliner N; Department of Hematology, Erasmus MC Cancer Institute and Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • Rego EM; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Blood ; 144(12): 1257-1270, 2024 Sep 19.
Article en En | MEDLINE | ID: mdl-38805638
ABSTRACT
ABSTRACT The introduction of all-trans retinoic acid combined with anthracyclines has significantly improved the outcomes for patients diagnosed with acute promyelocytic leukemia (APL), and this strategy remains the standard of care in countries in which arsenic trioxide is not affordable. However, data from national registries and real-world databases indicate that low- and middle-income countries (LMIC) still face disappointing results, mainly because of high induction mortality and suboptimal management of complications. The American Society of Hematology established the International Consortium on Acute Leukemias (ICAL) to address this challenge through international clinical networking. Here, we present the findings from the International Consortium on Acute Promyelocytic Leukemia study involving 806 patients with APL recruited from 2005 to 2020 in Brazil, Chile, Paraguay, Peru, and Uruguay. The induction mortality rate has notably decreased to 14.6% compared with the pre-ICAL rate of 32%. Multivariable logistic regression analysis revealed as factors associated with induction death age of ≥40 years, Eastern Cooperative Oncology Group performance status score of 3, high-risk status based on the Programa Español de Tratamiento en Hematologia/Gruppo Italiano Malattie EMatologiche dell'Adulto classification, albumin level of ≤3.5 g/dL, bcr3 PML/RARA isoform, the interval between presenting symptoms to diagnosis exceeding 48 hours, and the occurrence of central nervous system and pulmonary bleeding. With a median follow-up of 53 months, the estimated 4-year overall survival rate is 81%, the 4-year disease-free survival rate is 80%, and the 4-year cumulative incidence of relapse rate is 15%. These results parallel those observed in studies conducted in high-income countries, highlighting the long-term effectiveness of developing clinical networks to improve clinical care and infrastructure in LMIC.
Asunto(s)
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Promielocítica Aguda Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Blood Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Promielocítica Aguda Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Blood Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos