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Front-line Treatment of Acute Promyelocytic Leukemia With AIDA Induction Followed by Risk-Adapted Consolidation for Adults Younger Than 61 Years: Results of the AIDA-2000 Trial of the GIMEMA Group

Front-line Treatment of Acute Promyelocytic Leukemia With AIDA Induction Followed by Risk-Adapted Consolidation for Adults Younger Than 61 Years: Results of the AIDA-2000 Trial of the GIMEMA Group

Francesco Lo-Coco, Giuseppe Avvisati, Marco Vignetti, Massimo Breccia, Eugenio Gallo, Alessandro Rambaldi, Francesca Paoloni, Giuseppe Fioritoni, Felicetto Ferrara, Giorgina Specchia, Giuseppe Cimino, Daniela Diverio, etc.

Blood. 2010 Oct 28;116(17):3171-9.

PMID: 20644121

Abstract:

After the identification of discrete relapse-risk categories in patients with acute promyelocytic leukemia (APL) receiving all-trans retinoic and idarubicin (AIDA)-like therapies, the Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA) designed a protocol for newly diagnosed APL (AIDA-2000) in which postremission treatment was risk-adapted. Patients with low/intermediate risk received remission at 3 anthracycline-based consolidation courses, whereas high-risk patients received the same schedule as in the previous, non-risk-adapted AIDA-0493 trial including cytarabine. In addition, all patients in the AIDA-2000 received all-trans retinoic acid (ATRA) for 15 days during each consolidation. After induction, 600 of 636 (94.3%) and 420 of 445 (94.4%) patients achieved complete remission in the AIDA-0493 and AIDA-2000, respectively. The 6-year overall survival and cumulative incidence of relapse (CIR) rates were 78.1% versus 87.4% (P = .001) and 27.7% versus 10.7% (P < .0001). Significantly lower CIR rates for patients in the AIDA-2000 were most evident in the high-risk group (49.7% vs 9.3%, respectively, P < .0001). Our data confirm that anthracycline-based consolidation is at least equally effective as cytarabine-containing regimens for low-/intermediate-risk patients and suggest that a risk-adapted strategy including ATRA for consolidation improves outcome in newly diagnosed APL. Furthermore, our results highlight the role of cytarabine coupled to anthracyclines and ATRA during consolidation in the high-risk group.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP168560790	AIDA		168560-79-0	Price

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