Onkológia 5/2022

Twenty years of treatment of acute promyelocytic leukemia in National Cancer Institute

Purpose: Presentation of adapted NCI protocol development according to the results of clinical studies of leukemic groups and analyze the outcome of acute promyelocytic leukemia in National cancer Institute in Bratislava. Material and Methods: Since october 2002 till september 2022 we retrospectively analysed biological characteristics and survival of patients with APL treated with adapted protocols of well-known leukemic groups. Results: We diagnosed 47 patients with APL and median age 50 years (20-83y). According to risk stratification 17 (36,2%) patients were in high risk, 25 (53,2%) patients intermediate and 5(10,6%) patients in low risk group. Complete remission with MRD negativity (MR MRDneg) was achieved by 34 (82,9%) of patients. In the ATRA+CHT subgroup at median survival time 82 months (0,26-218months) was 3-year OS 65,4% (45,9%-84,9%) and 3-year DFS 87,8% (72,0%-100,0 and high risk %). According to risk stratification, the OS of patients in standard and high risk group was 72,9% (46,4%-99,5%) and 45,7% (15,3% - 76,2%), HR 0,35 (CI95% 0,09-1,33); p=0,12 and 3-years DFS in standard and high risk group was 79,6% (54%-100%) and 83,3% (53,5%-100%), HR 0,85 (0,07-10,06); p=0,89. In the subgroup of patients treated with ATRA +ATO at median survival time 22 months was 3-year OS 94,1%(82,9%-100%) and DFS 100%. Conclusion: Conducting own clinical studies and treatment protocols for such a rare diagnosis as APL within Slovakia, it wouldn´t lead to meaningful results and therefore patients are usually treated according to adapted protocols of well-known leukemic groups.

Keywords: acute promyelocytic leukemia, treatment, survival, ATO, ATRA