Prognostic factors of patients with newly diagnosed acute promyelocytic leukemia treated with arsenic trioxide-based frontline therapy
Prognostic factors of patients with newly diagnosed acute promyelocytic leukemia treated with arsenic trioxide-based frontline therapy
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DOI：
10.1016/j.leukres.2015.05.016
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发表时间：
2015-09-01
影响因子：
2.7
通讯作者：
Jin, Jie
中科院分区：
文献类型：
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作者：
Lou, Yinjun;Ma, Yafang;Jin, Jie
急性早幼粒细胞白血病（APL）患者接受三氧化二砷（ATO）一线治疗的预后因素尚未明确。我们回顾性分析184例连续接受静脉ato治疗的新诊断APL患者的临床特征、免疫表型、fms样酪氨酸激酶-3内串联重复（FLT3-ITD）和预后。中位年龄为40岁（14-77岁）。早期死亡率为4.9%（9/184例）。中位随访时间36个月（9-74个月），3年无复发生存期（RFS）和总生存期（OS）分别为93.3%和92.2%。有趣的是，3年RFS与初始白细胞计数、FLT3-ITD状态或PML-RARA亚型类型之间没有显著关联。在多变量分析中，CD56表达是RFS方面唯一的独立危险因素（风险比，4.70；P=0.005）。这些结果表明，以ato为基础的治疗可以改善先前已知的高危特征的不利影响；此外，CD56表达仍然是APL患者潜在的不利预后因素。(C) 2015 Elsevier Ltd.版权所有。
Prognostic factors for patients with acute promyelocytic leukemia (APL) treated in the context of arsenic trioxide (ATO)-based frontline regimes have not been established clearly. We retrospectively analyzed the clinical features, immunophenotypes, Fms-like tyrosine kinase-3 internal tandem duplication (FLT3-ITD), and outcomes of 184 consecutive newly diagnosed APL patients treated by intravenous ATO-based therapy. The median age was 40 years (14-77 years). The early death rate was 4.9% (9/184 patients). With a median follow-up time of 36 months (9-74 months), the 3-year relapse-free survival (RFS) and overall survival (OS) were 93.3% and 92.2%, respectively. Interestingly, there was no meaningful association between 3-year RFS and initial white blood cell count, FLT3-ITD status, or type of PML-RARA isoforms. In multivariable analysis, the CD56 expression was the only independent risk factor in terms of RFS (hazard ratio, 4.70; P=0.005). These results suggested that ATO-based therapy may ameliorate the unfavorable influence of previously known high-risk features; moreover, CD56 expression remains to be a potentially unfavorable prognostic factor in APL patients. (C) 2015 Elsevier Ltd. All rights reserved.