Improving acute promyelocytic leukemia (APL) outcome in developing countries through networking, results of the International Consortium on APL

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Rego, Eduardo M. ^{[1, 2]} ; Kim, Haesook T. ^[3] ; Ruiz-Argueelles, Guillermo J. ^[4] ; Undurraga, Maria Soledad ^[5] ; Uriarte, Maria del Rosario ^[6] ; Jacomo, Rafael H. ^{[1, 2]} ; Gutierrez-Aguirre, Homero ^[7] ; Melo, Raul A. M. ^[8] ; Bittencourt, Rosane ^[9] ; Pasquini, Ricardo ^[10] ; Pagnano, Katia ^[11] ; Fagundes, Evandro M. ^[12] ; Chauffaille, Maria de Lourdes ^[13] ; Chiattone, Carlos S. ^[14] ; Martinez, Lem ^[6] ; Meillon, Luis A. ^[15] ; Gomez-Almaguer, David ^[7] ; Kwaan, Hau C. ^[16] ; Garces-Eisele, Javier ^[4] ; Gallagher, Robert ^[17] ; Niemeyer, Charlotte M. ^[18] ; Schrier, Stanley L. ^[19] ; Tallman, Martin ^[20] ; Grimwade, David ^[21] ; Ganser, Arnold ^[22] ; Berliner, Nancy ^[23] ; Ribeiro, Raul C. ^[24] ; Lo-Coco, Francesco ^{[25, 26]} ; Loewenberg, Bob ^[27] ; Sanz, Miguel A. ^[28]

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^[1] Univ Sao Paulo, Hematol Oncol Div, Dept Internal Med, Med Sch Ribeirao Preto, BR-14048900 Ribeirao Preto - Brazil

^[2] Univ Sao Paulo, Ctr Cell Based Therapy, BR-14048900 Ribeirao Preto - Brazil

^[3] Dana Farber Canc Inst, Dept Biostat & Computat Biol, Boston, MA 02115 - USA

^[4] Clin Ruiz Puebla, Puebla - Mexico

^[5] Hosp Salvador, Dept Hematol, Santiago - Chile

^[6] Asociac Espanola Primera Socorros Mutuos, Montevideo - Uruguay

^[7] Hosp Univ Dr Jose E Gonzalez, Div Hematol, Monterrey - Mexico

^[8] Fundacao HEMOPE, Recife, PE - Brazil

^[9] Univ Fed Rio Grande do Sul, Div Hematol, Porto Alegre, RS - Brazil

^[10] Univ Fed Parana, Div Hematol, BR-80060000 Curitiba, Parana - Brazil

^[11] Univ Campinas UNICAMP, Hematol & Hemotherapy Ctr, Campinas - Brazil

^[12] Univ Fed Minas Gerais, Div Hematol, Belo Horizonte, MG - Brazil

^[13] Univ Fed Sao Paulo, Sao Paulo - Brazil

^[14] Santa Casa Med Sch, Div Hematol, Sao Paulo - Brazil

^[15] Ctr Med Nacl Siglo XXI, Mexico City, DF - Mexico

^[16] Northwestern Univ, Feinberg Sch Med, Hematol Oncol Div, Chicago, IL 60611 - USA

^[17] Albert Einstein Canc Ctr, New York, NY - USA

^[18] Univ Med Ctr, Dept Pediat & Adolescent Med, Freiburg - Germany

^[19] Stanford Univ, Dept Med, Stanford, CA 94305 - USA

^[20] Mem Sloan Kettering Canc Ctr, Dept Med, Leukemia Serv, Weill Cornell Med Coll, New York, NY 10021 - USA

^[21] Kings Coll London Sch Med, Dept Med & Mol Genet, London - England

^[22] Hannover Med Sch, Dept Hematol Hemostasis Oncol & Stem Cell Transpl, Hannover - Germany

^[23] Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 - USA

^[24] St Jude Childrens Res Hosp, Dept Oncol, Memphis, TN 38105 - USA

^[25] Univ Roma Tor Vergata, Dept Biopathol, Rome - Italy

^[26] Santa Lucia Fdn, Rome - Italy

^[27] Erasmus MC, Dept Hematol, Rotterdam - Netherlands

^[28] Valencia Univ Med Sch, Hosp Univ La Fe, Dept Hematol, Valencia - Spain

• Tipo de documento: Artigo Científico
• Fonte: Blood; v. 121, n. 11, p. 1935-1943, MAR 14 2013.
• Citações Web of Science: 35

Resumo

Thanks to modern treatment with all-trans retinoic acid and chemotherapy, acute promyelocytic leukemia (APL) is now the most curable type of leukemia. However, this progress has not yielded equivalent benefit in developing countries. The International Consortium on Acute Promyelocytic Leukemia (IC-APL) was established to create a network of institutions in developing countries that would exchange experience and data and receive support from well-established US and European cooperative groups. The IC-APL formulated expeditious diagnostic, treatment, and supportive guidelines that were adapted to local circumstances. APL was chosen as a model disease because of the potential impact on improved diagnosis and treatment. The project included 4 national coordinators and reference laboratories, common clinical record forms, 5 subcommittees, and laboratory and data management training programs. In addition, participating institutions held regular virtual and face-to-face meetings. Complete hematological remission was achieved in 153/180 (85%) patients and 27 (15%) died during induction. After a median follow-up of 28 months, the 2-year cumulative incidence of relapse, overall survival (OS), and disease-free survival (DFS) were 4.5%, 80%, and 91%, respectively. The establishment of the IC-APL network resulted in a decrease of almost 50% in early mortality and an improvement in OS of almost 30% compared with historical controls, resulting in OS and DFS similar to those reported in developed countries. (AU)

• Processo FAPESP: 98/14247-6 - Center for Research on Cell-Based Therapy
• Beneficiário: Marco Antonio Zago
• Modalidade de apoio: Auxílio à Pesquisa - Centros de Pesquisa, Inovação e Difusão - CEPIDs