ISSN:
1569-8041
Keywords:
acute promyelocytic
;
all-trans-retinoic acid
;
elderly
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background: To evaluate the role and toxicity of ATRA therapy innewly-diagnosed APL patients aged 〉60 yrs, the outcome of 16 consecutiveelderly APL patients observed between January 1990 and June 1996 wereanalyzed. Patients and methods: Their median age was 65.5 yrs (range 60–81years), the male/female ratio was 7 : 9, and molecular biology analysisshowed a PML/RARa rearrangement in all patients. Seven patients had aconcomitant cardiovascular disease. ATRA 45 mg/sqm/day was given to allpatients, and in 11 was associated with idarubicin (AIDA protocol); in twopatients ATRA was associated with mitoxantrone + ara-C, while the remainingthree patients received ATRA alone. Results: Fourteen patients (87.5%) achieved CR, and two patients(12.5%) died during induction. Despite the high CR rate, eightepisodes of severe cardiovascular complication were observed in sevenpatients, three of whom had previously had cardiovascular disease; inaddition, three patients had sepsis (two bacterial and one fungal). As of 31March 1997, 9 of 14 patients were still in first CR after a 19-month (range7-64 months) median follow-up since attainment of the CR. One patient diedin CR of a fungal complication and four patients relapsed after 8, 9, 23 and35 months following CR; two of them achieved a second CR lasting seven and+15 months with ATRA alone. Of the nine patients still in first CR, onlythree have received the planned consolidation therapy and five have been inCR for more than 24 months (+25, +33, +34, +38, +63). Conclusions: Despite the fact that most of these patients received shorterconsolidation treatments than do younger patients, the goodresults achieved in them might be considered an indication for modifyingtreatment schedules in order to reduce severe toxicity and improve protocolcompliance.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008272817839
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