Acute promyelocytic leukaemia: population-based study of epidemiology and outcome with ATRA and oral-ATO from 1991 to 2021
Abstract Background The epidemiology and treatment of acute promyelocytic leukaemia (APL) are changing. We have incorporated oral arsenic trioxide (oral-ATO) into induction/maintenance. Methods Newly-diagnosed APL from 1991 to 2021 divided into three 10-year periods were studied to define its epidem...
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| Format: | Article |
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BMC
2023-02-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-023-10612-z |
| _version_ | 1811165879033921536 |
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| author | Harinder Gill Radha Raghupathy Carmen Y.Y. Lee Yammy Yung Hiu-Tung Chu Michael Y. Ni Xiao Xiao Francis P. Flores Rita Yim Paul Lee Lynn Chin Vivian W.K. Li Lester Au Wing-Yan Au Edmond S.K. Ma Diwakar Mohan Cyrus Rustam Kumana Yok-Lam Kwong |
| author_facet | Harinder Gill Radha Raghupathy Carmen Y.Y. Lee Yammy Yung Hiu-Tung Chu Michael Y. Ni Xiao Xiao Francis P. Flores Rita Yim Paul Lee Lynn Chin Vivian W.K. Li Lester Au Wing-Yan Au Edmond S.K. Ma Diwakar Mohan Cyrus Rustam Kumana Yok-Lam Kwong |
| author_sort | Harinder Gill |
| collection | DOAJ |
| description | Abstract Background The epidemiology and treatment of acute promyelocytic leukaemia (APL) are changing. We have incorporated oral arsenic trioxide (oral-ATO) into induction/maintenance. Methods Newly-diagnosed APL from 1991 to 2021 divided into three 10-year periods were studied to define its epidemiology and how oral-ATO impacted on its outcome. Primary endpoints included APL incidence, early deaths (ED, first 30 days), and overall survival (OS). Secondary endpoints included post-30-day OS, relapse-free survival (RFS), and incidence of second cancers. Results APL occurred in 374 males and 387 females at a median age of 44 (1–97) years. Annual incidences increased progressively, averaging 0.32 per 100,000 people. All-trans retinoic acid (ATRA)-based and oral-ATO-based regimens were used in 469 and 282 patients. There were 144 EDs, occurring almost exclusively in ATRA-based inductions (N = 139), being more with males, age > 50 years, leucocyte > 10 × 109/L, diagnosis during 1991–2009 and fewer with oral-ATO-based regimens. After a median of 75 (interquartile range: 14–161) months, 5-year and 10-year OS were 68.1% and 63.3%, inferior with males, age > 50 years, leucocyte > 10 × 109/L, high-risk Sanz score and superior with oral-ATO-based regimens. Factoring out EDs, 5-year and 10-year post-30-day OS were 84.0% and 78.1%, inferior with males and superior with oral-ATO-based regimens. In 607 CR1 patients, the 5-year RFS was 83.8%, superior with diagnosis in 2010–2021 and oral-ATO-based regimens. Second cancers developed in 21 patients, unrelated to oral-ATO-based regimens. Conclusions There was an increasing incidence of APL, and all survivals were superior with the use of oral-ATO-based regimens. This study formed part of the Acute Promyelocytic Leukaemia Asian Consortium Project (ClinicalTrials.gov identifier: NCT04251754). |
| first_indexed | 2024-04-10T15:44:35Z |
| format | Article |
| id | doaj.art-c6e19c5014b74121914b1a74c9edba0a |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-10T15:44:35Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-c6e19c5014b74121914b1a74c9edba0a2023-02-12T12:14:40ZengBMCBMC Cancer1471-24072023-02-0123111410.1186/s12885-023-10612-zAcute promyelocytic leukaemia: population-based study of epidemiology and outcome with ATRA and oral-ATO from 1991 to 2021Harinder Gill0Radha Raghupathy1Carmen Y.Y. Lee2Yammy Yung3Hiu-Tung Chu4Michael Y. Ni5Xiao Xiao6Francis P. Flores7Rita Yim8Paul Lee9Lynn Chin10Vivian W.K. Li11Lester Au12Wing-Yan Au13Edmond S.K. Ma14Diwakar Mohan15Cyrus Rustam Kumana16Yok-Lam Kwong17Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongSchool of Public Health, LKS Faculty of Medicine, The University of Hong KongSchool of Public Health, LKS Faculty of Medicine, The University of Hong KongSchool of Public Health, LKS Faculty of Medicine, The University of Hong KongDepartment of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongBlood-Med ClinicDepartment of Pathology, Hong Kong Sanatorium and HospitalDivision of Global Disease Epidemiology and Control, Department of International Health, John Hopkins Bloomberg School of Public HealthDepartment of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongAbstract Background The epidemiology and treatment of acute promyelocytic leukaemia (APL) are changing. We have incorporated oral arsenic trioxide (oral-ATO) into induction/maintenance. Methods Newly-diagnosed APL from 1991 to 2021 divided into three 10-year periods were studied to define its epidemiology and how oral-ATO impacted on its outcome. Primary endpoints included APL incidence, early deaths (ED, first 30 days), and overall survival (OS). Secondary endpoints included post-30-day OS, relapse-free survival (RFS), and incidence of second cancers. Results APL occurred in 374 males and 387 females at a median age of 44 (1–97) years. Annual incidences increased progressively, averaging 0.32 per 100,000 people. All-trans retinoic acid (ATRA)-based and oral-ATO-based regimens were used in 469 and 282 patients. There were 144 EDs, occurring almost exclusively in ATRA-based inductions (N = 139), being more with males, age > 50 years, leucocyte > 10 × 109/L, diagnosis during 1991–2009 and fewer with oral-ATO-based regimens. After a median of 75 (interquartile range: 14–161) months, 5-year and 10-year OS were 68.1% and 63.3%, inferior with males, age > 50 years, leucocyte > 10 × 109/L, high-risk Sanz score and superior with oral-ATO-based regimens. Factoring out EDs, 5-year and 10-year post-30-day OS were 84.0% and 78.1%, inferior with males and superior with oral-ATO-based regimens. In 607 CR1 patients, the 5-year RFS was 83.8%, superior with diagnosis in 2010–2021 and oral-ATO-based regimens. Second cancers developed in 21 patients, unrelated to oral-ATO-based regimens. Conclusions There was an increasing incidence of APL, and all survivals were superior with the use of oral-ATO-based regimens. This study formed part of the Acute Promyelocytic Leukaemia Asian Consortium Project (ClinicalTrials.gov identifier: NCT04251754).https://doi.org/10.1186/s12885-023-10612-zAcute promyelocytic leukaemiaEpidemiologyOral arsenic trioxideEarly deathsSurvivalsSecond primary cancers |
| spellingShingle | Harinder Gill Radha Raghupathy Carmen Y.Y. Lee Yammy Yung Hiu-Tung Chu Michael Y. Ni Xiao Xiao Francis P. Flores Rita Yim Paul Lee Lynn Chin Vivian W.K. Li Lester Au Wing-Yan Au Edmond S.K. Ma Diwakar Mohan Cyrus Rustam Kumana Yok-Lam Kwong Acute promyelocytic leukaemia: population-based study of epidemiology and outcome with ATRA and oral-ATO from 1991 to 2021 BMC Cancer Acute promyelocytic leukaemia Epidemiology Oral arsenic trioxide Early deaths Survivals Second primary cancers |
| title | Acute promyelocytic leukaemia: population-based study of epidemiology and outcome with ATRA and oral-ATO from 1991 to 2021 |
| title_full | Acute promyelocytic leukaemia: population-based study of epidemiology and outcome with ATRA and oral-ATO from 1991 to 2021 |
| title_fullStr | Acute promyelocytic leukaemia: population-based study of epidemiology and outcome with ATRA and oral-ATO from 1991 to 2021 |
| title_full_unstemmed | Acute promyelocytic leukaemia: population-based study of epidemiology and outcome with ATRA and oral-ATO from 1991 to 2021 |
| title_short | Acute promyelocytic leukaemia: population-based study of epidemiology and outcome with ATRA and oral-ATO from 1991 to 2021 |
| title_sort | acute promyelocytic leukaemia population based study of epidemiology and outcome with atra and oral ato from 1991 to 2021 |
| topic | Acute promyelocytic leukaemia Epidemiology Oral arsenic trioxide Early deaths Survivals Second primary cancers |
| url | https://doi.org/10.1186/s12885-023-10612-z |
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