This is a multicenter, observational real world clinical trial with prospective follow up that will evaluate the treatment outcome of acute promyelocytic leukemia (APL) patients in the first line with arsenic trioxide and all trans retinoic acid (ATO/ATRA) based regimens in Argentina.
The purpose of this trial is to gather real world evidence of the characteristics of APL patients in Argentina who receive ATO/ATRA based treatment in first line following our national guidelines. The study primary endpoint is to evaluate event free survival and overall survival of patients diagnosed with APL and treated in first line with ATO/ATRA or ATO/ATRA/Idarubicin (IDA) depending on risk category. Secondary endpoints are complete molecular response (CMR) rate, toxicity, early mortality and prognostic significance of FLT3. Every APL patient diagnosed in our institutions will follow our guidelines with respect to diagnosis procedures. Risk category will depend on white blood cell counts (WBC), where WBC \>10000 will be considered high risk (HR) and \<10000 WBC, low risk (LR). Patients will receive induction with ATO plus ATRA daily until hematologic remission or for a maximum of 60 days, followed by ATO 5 days/week, 4 weeks on 4 weeks off, for a total of 4 courses and ATRA 2 weeks on and 2 weeks off for a total of 7 courses. HR patients will receive 2-3 doses of IDA at the beginning of induction. Central nervous system prophylaxis is contemplated for HR pts or those who have SNC bleeding. Molecular response will be evaluated at the end of consolidation by RQ-PCR. LR patients who achieve CMR will not need to repeat molecular evaluations but HR patients will need RQ-PCR evaluation every 3 months during the first year and every 6 months during the second year.
Study Type
OBSERVATIONAL
Enrollment
50
Evaluation of first line treatment with ATO/ATRA outcome (o event free survival and overall survival and toxicity) in adult patients with APL.
Hospital Italiano de La Plata
La Plata, Buenos Aires, Argentina
RECRUITINGInstituto Privado de Hematologia y Hemoterapia
Paraná, Entre Ríos Province, Argentina
RECRUITINGHospital Escuela de Agudos Dr. Ramón Madariaga
Posadas, Misiones Province, Argentina
Evaluate overall survival of patients diagnosed with APL and treated in first line with ATO/ATRA or ATO/ATRA/Idarubicin (IDA).
Evaluate overall survival of patients \>/= 18 years old diagnosed with APL and treated in first line with ATO/ATRA or ATO/ATRA/Idarubicin (IDA) depending on risk category.
Time frame: 36 months
Evaluate event free survival of patients diagnosed with APL and treated in first line with ATO/ATRA or ATO/ATRA/Idarubicin (IDA).
Evaluate event free survival of patients \>/= 18 years old diagnosed with APL and treated in first line with ATO/ATRA or ATO/ATRA/Idarubicin (IDA) depending on risk category.
Time frame: 36 months
Evaluate complete molecular remission rate at the end of the consolidation treatment.
Time frame: 36 months
Evaluate toxicity of the ATO/ATRA scheme (+/- IDA), measured according to type, frequency, severity and relation with the treatment of adverse events.
Time frame: 36 months
Record early mortality (within 30 days of admission).
Time frame: Within 30 days of admission
Evaluate whether the presence of mutated FLT3 has prognostic value in patients treated with ATRA/ATO.
The prognostic value will be analyzed by comparing rates of complete remission (CR), hematological relapse, molecular relapse, PFS and OS.
Time frame: 36 months
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Hospital Descentralizado Dr. Guillermo Rawson
Rawson, San Juan Province, Argentina
RECRUITINGCEMIC
CABA, Argentina
RECRUITINGFUNDALEU
CABA, Argentina
RECRUITING