Real life outcomes of patients aged ≥75 years old with acute promyelocytic leukemia: experience of the PETHEMA registry

Salamero, Olga; Martínez-Cuadrón, David; Sobas, Marta; Benavente, Celina; Susana, Vives; de la Serna, Javier; Pérez Encinas, Manuel Mateo; Escoda, Lourdes; Gil, Cristina; Brunet, Salut; Ramos, Fernando; Esteve, Jordi; Amigo, Mariluz; Krsnik, Isabel; Manso, Félix; Arias Sampedro, Jesús; González-Campos, José; Serrano, Josefina; Oleksiuk, Jalanta; Barrios, Manuel; García-Boyero, Raimundo; Novo, Andrés; Sanz, Miguel A.; Montesinos, Pau
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Date issued
2019
Journal title
Leukemia & Lymphoma
Type of content
Artigo
DeCS
leucemia promielocítica aguda | resultado del tratamiento | protocolos de quimioterapia antineoplásica combinada | tretinoina | estudios de cohortes | humanos | inducción de remisión | anciano | sistema de registros | estudios de seguimiento | tasa de supervivencia
MeSH
Aged | Treatment Outcome | Follow-Up Studies | Humans | Cohort Studies | Remission Induction | Leukemia, Promyelocytic, Acute | Registries | Antineoplastic Combined Chemotherapy Protocols | Survival Rate | Tretinoin
CIE
Leucemia promielocítica aguda
Abstract
[EN] Acute promyelocytic leukemia is infrequent among patients aged ≥75 years old, a population that is rarely eligible for clinical protocols. This study aims to analyze the treatment strategies and clinical outcomes of very old APL patients reported to the international PETHEMA registry. Between 1997 and 2017, among 2501 APL cases registered 120 were ≥75 years old. Treatment approaches were: AIDA regimen, 79 patients; ATRA alone, 23; 16, supportive care (SC) and 2, other strategies. Patients treated with AIDA were younger, had better ECOG and lower leukocytes. Complete remission (CR) was achieved in 65% of AIDA-group vs. 45% in the ATRA-group, being infections followed by bleeding the most frequent causes of induction death. Patients in CR after AIDA showed 3-year DFS of 73%. Our real-life series of very old APL patients provides a reference basis for future treatment strategies aiming to improve clinical outcomes in this challenging population.