Recurrences of acute promyelocytic leukemia in children: experience with arsenic trioxide therapy and autologous hemopoietic cell transplantation
- 作者: Baidildina DD1, Maschan MA2, Skorobogatova EV1, Dubrovina ME1, Rumyantseva Y.V2, Maschan AA1, Rumyantsev AG2, Samochatova EV1
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隶属关系:
- Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationRussian Children's Hospital, Moscow
- Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation
- 期: 卷 82, 编号 7 (2010)
- 页面: 20-25
- 栏目: Editorial
- ##submission.dateSubmitted##: 09.04.2020
- ##submission.datePublished##: 15.07.2010
- URL: https://ter-arkhiv.ru/0040-3660/article/view/30599
- ID: 30599
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Subjects and methods. The study included 9 patients with recurrent APL. The recurrences developed significantly more frequently in a very high-risk group (patients with minimal residual disease being preserved after the intensive therapy phase). Induction used arsenic trioxide (ATO) and/or standard chemotherapy + ATRA; ATO monotherapy was in consolidation. CD34+ cells were mobilized until molecular remission was achieved with high-dose Ara-C and granulocyte colony-stimulating factor. Pretransplantation conditioning involved melfalan as a basic drug in combination with high-dose Ara-C (5 pts), treosulfan (1 pt) or bisulfan (1 pt). Six patients received gemtusumab ozogamicin, 3-9 mg/m2, at different stages of therapy.
Results. Before therapy one patient died; 8 patients achieved the second molecular remission; CD34+ cell mobilization and sampling were effective in 7 cases. Five patients were in long-term molecular remission after autologous hemopoietic stem cell transplantation (autoHSCT). Follow-up was 23-40 months. One patient is being prepared for transplantation. Following autoHSCT, another patient with a developed repeat recurrence died from complications due to related partially compatible transplantation. Visceral, including cardiological, toxicity of therapy was insignificant. In the APL-2003 protocol, overall and event-free survival rates were 93±3 and 76±6%, respectively.
Conclusion. The application of ATO and autoHSCT in recurrent APL makes it possible to achieve and preserve the second molecular remission in case of insignificant extrahematological toxicity. Russian clinics should have access to ATO.
作者简介
D Baidildina
Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationRussian Children's Hospital, MoscowFederal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationRussian Children's Hospital, Moscow
M Maschan
Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationFederal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation
E Skorobogatova
Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationRussian Children's Hospital, MoscowFederal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationRussian Children's Hospital, Moscow
M Dubrovina
Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationRussian Children's Hospital, MoscowFederal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationRussian Children's Hospital, Moscow
Yu Rumyantseva
Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationFederal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation
A Maschan
Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationRussian Children's Hospital, Moscow
Email: amaschan@mail.ru
Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationRussian Children's Hospital, Moscow
A Rumyantsev
Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationFederal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation
E Samochatova
Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationRussian Children's Hospital, MoscowFederal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian FederationRussian Children's Hospital, Moscow
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