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Prompt Initiation of Conventional Chemotherapy to Avoid Early Death in Patients with Newly Diagnosed Acute Promyelocytic Leukemia

OBJECTIVE: Compared to prospective trials, the early death rate of newly diagnosed acute promyelocytic leukemia (APL) in the real-world clinical setting is higher. However, the early death rate was heterogeneous according to the reported institutes. Thus, the therapeutic approach at each institute m...

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Autores principales: Matsuda, Kensuke, Oyama, Takashi, Maki, Hiroaki, Nakazaki, Kumi, Yasunaga, Megumi, Honda, Akira, Masamoto, Yosuke, Kurokawa, Mineo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10465272/
https://www.ncbi.nlm.nih.gov/pubmed/36476552
http://dx.doi.org/10.2169/internalmedicine.0937-22
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author Matsuda, Kensuke
Oyama, Takashi
Maki, Hiroaki
Nakazaki, Kumi
Yasunaga, Megumi
Honda, Akira
Masamoto, Yosuke
Kurokawa, Mineo
author_facet Matsuda, Kensuke
Oyama, Takashi
Maki, Hiroaki
Nakazaki, Kumi
Yasunaga, Megumi
Honda, Akira
Masamoto, Yosuke
Kurokawa, Mineo
author_sort Matsuda, Kensuke
collection PubMed
description OBJECTIVE: Compared to prospective trials, the early death rate of newly diagnosed acute promyelocytic leukemia (APL) in the real-world clinical setting is higher. However, the early death rate was heterogeneous according to the reported institutes. Thus, the therapeutic approach at each institute may be important for preventing early death. This study evaluated the management strategy for untreated APL in our institute to avoid early death. METHODS: We identified consecutive 21 patients with untreated APL who received induction therapy including all-trans retinoic acid (ATRA) between July 2007 and December 2021 at the University of Tokyo Hospital. RESULTS: As therapeutic approaches, 16 patients (76%) received ATRA administration on the day of admission, and the remaining 5 received ATRA within 4 days from admission. Notably, all patients received conventional chemotherapy added to ATRA at a median of 1 day from admission (range: 0-9 days). As clinical outcomes, no patient died during induction therapy for untreated APL, and all achieved complete molecular remission. CONCLUSION: Compared to the previous nationwide survey, a higher proportion of patients at our institute received conventional chemotherapy in addition to ATRA, and it was initiated more promptly, which may have helped prevent early death.
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spelling pubmed-104652722023-08-30 Prompt Initiation of Conventional Chemotherapy to Avoid Early Death in Patients with Newly Diagnosed Acute Promyelocytic Leukemia Matsuda, Kensuke Oyama, Takashi Maki, Hiroaki Nakazaki, Kumi Yasunaga, Megumi Honda, Akira Masamoto, Yosuke Kurokawa, Mineo Intern Med Original Article OBJECTIVE: Compared to prospective trials, the early death rate of newly diagnosed acute promyelocytic leukemia (APL) in the real-world clinical setting is higher. However, the early death rate was heterogeneous according to the reported institutes. Thus, the therapeutic approach at each institute may be important for preventing early death. This study evaluated the management strategy for untreated APL in our institute to avoid early death. METHODS: We identified consecutive 21 patients with untreated APL who received induction therapy including all-trans retinoic acid (ATRA) between July 2007 and December 2021 at the University of Tokyo Hospital. RESULTS: As therapeutic approaches, 16 patients (76%) received ATRA administration on the day of admission, and the remaining 5 received ATRA within 4 days from admission. Notably, all patients received conventional chemotherapy added to ATRA at a median of 1 day from admission (range: 0-9 days). As clinical outcomes, no patient died during induction therapy for untreated APL, and all achieved complete molecular remission. CONCLUSION: Compared to the previous nationwide survey, a higher proportion of patients at our institute received conventional chemotherapy in addition to ATRA, and it was initiated more promptly, which may have helped prevent early death. The Japanese Society of Internal Medicine 2022-12-07 2023-08-01 /pmc/articles/PMC10465272/ /pubmed/36476552 http://dx.doi.org/10.2169/internalmedicine.0937-22 Text en Copyright © 2023 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Matsuda, Kensuke
Oyama, Takashi
Maki, Hiroaki
Nakazaki, Kumi
Yasunaga, Megumi
Honda, Akira
Masamoto, Yosuke
Kurokawa, Mineo
Prompt Initiation of Conventional Chemotherapy to Avoid Early Death in Patients with Newly Diagnosed Acute Promyelocytic Leukemia
title Prompt Initiation of Conventional Chemotherapy to Avoid Early Death in Patients with Newly Diagnosed Acute Promyelocytic Leukemia
title_full Prompt Initiation of Conventional Chemotherapy to Avoid Early Death in Patients with Newly Diagnosed Acute Promyelocytic Leukemia
title_fullStr Prompt Initiation of Conventional Chemotherapy to Avoid Early Death in Patients with Newly Diagnosed Acute Promyelocytic Leukemia
title_full_unstemmed Prompt Initiation of Conventional Chemotherapy to Avoid Early Death in Patients with Newly Diagnosed Acute Promyelocytic Leukemia
title_short Prompt Initiation of Conventional Chemotherapy to Avoid Early Death in Patients with Newly Diagnosed Acute Promyelocytic Leukemia
title_sort prompt initiation of conventional chemotherapy to avoid early death in patients with newly diagnosed acute promyelocytic leukemia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10465272/
https://www.ncbi.nlm.nih.gov/pubmed/36476552
http://dx.doi.org/10.2169/internalmedicine.0937-22
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