Early Death and Survival of Patients With Acute Promyelocytic Leukemia in ATRA Plus Arsenic Era: A Population-Based Study
Most randomized trials for acute promyelocytic leukemia (APL) have investigated highly selected patients under idealized conditions, and the findings need to be validated in the real world. We conducted a population-based study of all APL patients in Zhejiang Province, China, with a total population...
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2021
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oai:doaj.org-article:721dcc7400fe4047baedb142e0c755062021-11-16T12:45:03ZEarly Death and Survival of Patients With Acute Promyelocytic Leukemia in ATRA Plus Arsenic Era: A Population-Based Study2234-943X10.3389/fonc.2021.762653https://doaj.org/article/721dcc7400fe4047baedb142e0c755062021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.762653/fullhttps://doaj.org/toc/2234-943XMost randomized trials for acute promyelocytic leukemia (APL) have investigated highly selected patients under idealized conditions, and the findings need to be validated in the real world. We conducted a population-based study of all APL patients in Zhejiang Province, China, with a total population of 82 million people, to assess the generalization of all-trans retinoic acid (ATRA) and arsenic as front-line treatment. The outcomes of APL patients were also analyzed. Between January 2015 and December 2019, 1,233 eligible patients were included in the final analysis. The rate of ATRA and arsenic as front-line treatment increased steadily from 66.2% in 2015 to 83.3% in 2019, with no difference among the size of the center (≥5 or <5 patients per year, p = 0.12) or age (≥60 or <60 years, p = 0.35). The early death (ED) rate, defined as death within 30 days after diagnosis, was 8.2%, and the 3-year overall survival (OS) was 87.9% in the whole patient population. Age (≥60 years) and white blood cell count (>10 × 109/L) were independent risk factors for ED and OS in the multivariate analysis. This population-based study showed that ATRA and arsenic as front-line treatment are widely used under real-world conditions and yield a low ED rate and a high survival rate, which mimic the results from clinical trials, thereby supporting the wider application of APL guidelines in the future.Hong-Hu ZhuHong-Hu ZhuHong-Hu ZhuHong-Hu ZhuYa-Fang MaKang YuGui-Fang OuyangWen-Da LuoRen-Zhi PeiWei-Qun XuHui-Xian HuShu-Ping MoXiao-Hua XuJian-Ping LanJian-Ping ShenLi-Hong ShouShen-Xian QianWei-Ying FengPu ZhaoJin-Hong JiangBei-Li HuJin ZhangSu-Ying QianGong-Qiang WuWen-Ping WuLei QiuLin-Jie LiXiang-Hua LangSai ChenLi-Li ChenJun-Bin GuoLi-Hong CaoHui-Fang JiangYong-Ming XiaJing LeJian-Zhi ZhaoJian HuangYue-Feng ZhangYa-Li LvJing-Sheng HuaYong-Wei HongCui-Ping ZhengJu-Xiang WangBin-Fei HuXiao-Hui ChenLi-Ming ZhangShi TaoBing-Shou XieYue-Min KuangWen-Ji LuoPing SuJun GuoXiao WuWei JiangHui-Qi ZhangYun ZhangChun-Mei ChenXiao-Feng XuYan GuoJin-Ming TuShao HuXiao-Yan YanChen YaoYin-Jun LouJie JinJie JinJie JinJie Jinthe APL Cooperative Group of Zhejiang ProvinceFrontiers Media S.A.articleacute promyelocytic leukemiaATRAarsenicearly deathsurvivalNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021) |
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EN |
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acute promyelocytic leukemia ATRA arsenic early death survival Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 |
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acute promyelocytic leukemia ATRA arsenic early death survival Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Hong-Hu Zhu Hong-Hu Zhu Hong-Hu Zhu Hong-Hu Zhu Ya-Fang Ma Kang Yu Gui-Fang Ouyang Wen-Da Luo Ren-Zhi Pei Wei-Qun Xu Hui-Xian Hu Shu-Ping Mo Xiao-Hua Xu Jian-Ping Lan Jian-Ping Shen Li-Hong Shou Shen-Xian Qian Wei-Ying Feng Pu Zhao Jin-Hong Jiang Bei-Li Hu Jin Zhang Su-Ying Qian Gong-Qiang Wu Wen-Ping Wu Lei Qiu Lin-Jie Li Xiang-Hua Lang Sai Chen Li-Li Chen Jun-Bin Guo Li-Hong Cao Hui-Fang Jiang Yong-Ming Xia Jing Le Jian-Zhi Zhao Jian Huang Yue-Feng Zhang Ya-Li Lv Jing-Sheng Hua Yong-Wei Hong Cui-Ping Zheng Ju-Xiang Wang Bin-Fei Hu Xiao-Hui Chen Li-Ming Zhang Shi Tao Bing-Shou Xie Yue-Min Kuang Wen-Ji Luo Ping Su Jun Guo Xiao Wu Wei Jiang Hui-Qi Zhang Yun Zhang Chun-Mei Chen Xiao-Feng Xu Yan Guo Jin-Ming Tu Shao Hu Xiao-Yan Yan Chen Yao Yin-Jun Lou Jie Jin Jie Jin Jie Jin Jie Jin the APL Cooperative Group of Zhejiang Province Early Death and Survival of Patients With Acute Promyelocytic Leukemia in ATRA Plus Arsenic Era: A Population-Based Study |
| description |
Most randomized trials for acute promyelocytic leukemia (APL) have investigated highly selected patients under idealized conditions, and the findings need to be validated in the real world. We conducted a population-based study of all APL patients in Zhejiang Province, China, with a total population of 82 million people, to assess the generalization of all-trans retinoic acid (ATRA) and arsenic as front-line treatment. The outcomes of APL patients were also analyzed. Between January 2015 and December 2019, 1,233 eligible patients were included in the final analysis. The rate of ATRA and arsenic as front-line treatment increased steadily from 66.2% in 2015 to 83.3% in 2019, with no difference among the size of the center (≥5 or <5 patients per year, p = 0.12) or age (≥60 or <60 years, p = 0.35). The early death (ED) rate, defined as death within 30 days after diagnosis, was 8.2%, and the 3-year overall survival (OS) was 87.9% in the whole patient population. Age (≥60 years) and white blood cell count (>10 × 109/L) were independent risk factors for ED and OS in the multivariate analysis. This population-based study showed that ATRA and arsenic as front-line treatment are widely used under real-world conditions and yield a low ED rate and a high survival rate, which mimic the results from clinical trials, thereby supporting the wider application of APL guidelines in the future. |
| format |
article |
| author |
Hong-Hu Zhu Hong-Hu Zhu Hong-Hu Zhu Hong-Hu Zhu Ya-Fang Ma Kang Yu Gui-Fang Ouyang Wen-Da Luo Ren-Zhi Pei Wei-Qun Xu Hui-Xian Hu Shu-Ping Mo Xiao-Hua Xu Jian-Ping Lan Jian-Ping Shen Li-Hong Shou Shen-Xian Qian Wei-Ying Feng Pu Zhao Jin-Hong Jiang Bei-Li Hu Jin Zhang Su-Ying Qian Gong-Qiang Wu Wen-Ping Wu Lei Qiu Lin-Jie Li Xiang-Hua Lang Sai Chen Li-Li Chen Jun-Bin Guo Li-Hong Cao Hui-Fang Jiang Yong-Ming Xia Jing Le Jian-Zhi Zhao Jian Huang Yue-Feng Zhang Ya-Li Lv Jing-Sheng Hua Yong-Wei Hong Cui-Ping Zheng Ju-Xiang Wang Bin-Fei Hu Xiao-Hui Chen Li-Ming Zhang Shi Tao Bing-Shou Xie Yue-Min Kuang Wen-Ji Luo Ping Su Jun Guo Xiao Wu Wei Jiang Hui-Qi Zhang Yun Zhang Chun-Mei Chen Xiao-Feng Xu Yan Guo Jin-Ming Tu Shao Hu Xiao-Yan Yan Chen Yao Yin-Jun Lou Jie Jin Jie Jin Jie Jin Jie Jin the APL Cooperative Group of Zhejiang Province |
| author_facet |
Hong-Hu Zhu Hong-Hu Zhu Hong-Hu Zhu Hong-Hu Zhu Ya-Fang Ma Kang Yu Gui-Fang Ouyang Wen-Da Luo Ren-Zhi Pei Wei-Qun Xu Hui-Xian Hu Shu-Ping Mo Xiao-Hua Xu Jian-Ping Lan Jian-Ping Shen Li-Hong Shou Shen-Xian Qian Wei-Ying Feng Pu Zhao Jin-Hong Jiang Bei-Li Hu Jin Zhang Su-Ying Qian Gong-Qiang Wu Wen-Ping Wu Lei Qiu Lin-Jie Li Xiang-Hua Lang Sai Chen Li-Li Chen Jun-Bin Guo Li-Hong Cao Hui-Fang Jiang Yong-Ming Xia Jing Le Jian-Zhi Zhao Jian Huang Yue-Feng Zhang Ya-Li Lv Jing-Sheng Hua Yong-Wei Hong Cui-Ping Zheng Ju-Xiang Wang Bin-Fei Hu Xiao-Hui Chen Li-Ming Zhang Shi Tao Bing-Shou Xie Yue-Min Kuang Wen-Ji Luo Ping Su Jun Guo Xiao Wu Wei Jiang Hui-Qi Zhang Yun Zhang Chun-Mei Chen Xiao-Feng Xu Yan Guo Jin-Ming Tu Shao Hu Xiao-Yan Yan Chen Yao Yin-Jun Lou Jie Jin Jie Jin Jie Jin Jie Jin the APL Cooperative Group of Zhejiang Province |
| author_sort |
Hong-Hu Zhu |
| title |
Early Death and Survival of Patients With Acute Promyelocytic Leukemia in ATRA Plus Arsenic Era: A Population-Based Study |
| title_short |
Early Death and Survival of Patients With Acute Promyelocytic Leukemia in ATRA Plus Arsenic Era: A Population-Based Study |
| title_full |
Early Death and Survival of Patients With Acute Promyelocytic Leukemia in ATRA Plus Arsenic Era: A Population-Based Study |
| title_fullStr |
Early Death and Survival of Patients With Acute Promyelocytic Leukemia in ATRA Plus Arsenic Era: A Population-Based Study |
| title_full_unstemmed |
Early Death and Survival of Patients With Acute Promyelocytic Leukemia in ATRA Plus Arsenic Era: A Population-Based Study |
| title_sort |
early death and survival of patients with acute promyelocytic leukemia in atra plus arsenic era: a population-based study |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/721dcc7400fe4047baedb142e0c75506 |
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