G. Deben | University of Santiago de Compostela (original) (raw)
Papers by G. Deben
British Journal of Haematology, 2005
Blood, 2004
Therapeutic results in elderly patients with acute promyelocytic leukemia (APL) have been general... more Therapeutic results in elderly patients with acute promyelocytic leukemia (APL) have been generally reported as less effective than for younger patients. Patients 60 years or older with APL who were enrolled in 2 successive multicenter PETHEMA studies received induction therapy with all-trans retinoic acid (ATRA) and idarubicin, consolidation with 3 anthracycline monochemotherapy courses with or without ATRA, and maintenance with ATRA and low-dose chemotherapy. Eighty-seven of 104 patients achieved complete remission (84%). Eightysix proceeded to consolidation therapy (2 withdrew after the first and second courses). Deaths in remission occurred during consolidation and maintenance therapy in 3 and 4 patients, respectively. One patient showed molecular persistence after consolidation and 5 had a relapse. The 6-year cumulative incidence of relapse, leukemia-free survival, and disease-free survival were 8.5%, 91%, and 79%, respectively. A significantly higher incidence of low-risk patients found among the elderly, as compared to younger patients, may partially account for the low relapse rate observed. This study confirms the high antileukemic efficacy, low toxicity, and high degree of compliance of protocols using ATRA and anthracycline monochemotherapy for induction and consolidation therapy in elderly patients.
Actas Dermo-Sifiliográficas, 2003
... Manuel Almagroa, Jesús del Pozoa, Jesús García-Silvaa, María Teresa Yebra-Pimentelb, Guillerm... more ... Manuel Almagroa, Jesús del Pozoa, Jesús García-Silvaa, María Teresa Yebra-Pimentelb, Guillermo Debenc y ... Paul C, Giachetti S, Pinquier L, Flageul B, Dubertret L, Calvo F. Cutaneous effects ... Fariña MC, Requena L, Dómine M, Soriano ML, Estévez L, Barat A. Histopathology ...
Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis, 2010
Between 30% and 60% of patients with thrombotic thrombocytopenic purpura (TTP) relapse and mortal... more Between 30% and 60% of patients with thrombotic thrombocytopenic purpura (TTP) relapse and mortality remains at 15-20%. Limited clinical data suggest that the administration of anti-CD20 antibody (rituximab) may be useful in preventing acute refractory and chronic relapsing TTP.
Blood, 2006
Introduction: CC analysis of the CSF is considered as the reference method to diagnose meningeal ... more Introduction: CC analysis of the CSF is considered as the reference method to diagnose meningeal disease in patients with B-NHL. However, recent studies suggest that in patients with B-NHL who are at high risk of CNS relapse, FCM could be more sensitive than CC for detecting meningeal disease in CSF. Objective: To evaluate the sensitivity and specificity of a standardized FCM immunophenotypic approach vs CC for detecting the presence of neoplastic cells in CSF, in patients with aggressive B-NHL who are at high risk of CNS relapse. Patients and methods: A total of 29 CSF samples were analysed (total volume: 0.8 to 4ml; median: 2.4) in newly diagnosed patients with aggressive B-NHL, from a total of 14 different hospitals (diffuse large B cell lymphoma-DLBCL: 17; Burkitt’s lymphoma-BL: 9; follicular lymphoma transformed to DLBCL -tFL: 2; and T-cell-rich B-NHL: 1). Of the 29 patients studied, 15 were men (52%) and 14 women (48%) with a mean age of 55 ± 19 years (range: 16–86). In all ca...
Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren, 1989
![Research paper thumbnail of [Pancoast syndrome and endobronchial tumor infiltration as the first manifestation of Hodgkin lymphoma]](https://attachments.academia-assets.com/50456823/thumbnails/1.jpg)
](Archivos de bronconeumología, 2004
The most common cause of Pancoast syndrome is bronchogenic carcinoma. Other less common causes ar... more The most common cause of Pancoast syndrome is bronchogenic carcinoma. Other less common causes are solid tumor metastases, other chest tumors, infections, and hematologic neoplasms. Pancoast syndrome due to lymphoma is very rare, and cases described in the literature are essentially associated with non-Hodgkin lymphomas. In a review of the literature we found a single case of Pancoast syndrome secondary to a Hodgkin lymphoma; however, the syndrome manifested during recurrence of disease in that patient. We report a case of nodular sclerosis Hodgkin lymphoma which first manifested clinically as Pancoast syndrome and which was initially diagnosed by bronchial biopsy.
RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 1989
Journal of Clinical Oncology, 2010
We analyzed the incidence, risk factors, and outcome of therapy-related myeloid neoplasms (t-MNs)... more We analyzed the incidence, risk factors, and outcome of therapy-related myeloid neoplasms (t-MNs) in patients with acute promyelocytic leukemia (APL) in first complete remission (CR). From 1996 to 2008, 1,025 patients with APL were enrolled onto three sequential trials (LPA96, LPA99, and LPA2005) of the Programa Español para el Tratamiento de Enfermedades Hematológicas and received induction and consolidation therapy with all-trans-retinoic acid (ATRA) and anthracycline-based chemotherapy. Seventeen of 918 patients who achieved CR developed t-MN (10 with < 20% and seven with…
Journal of Clinical Oncology, 2009
Here, we evaluate the sensitivity and specificity of a new 11-parameter flow cytometry (FCM) appr... more Here, we evaluate the sensitivity and specificity of a new 11-parameter flow cytometry (FCM) approach versus conventional cytology (CC) for detecting neoplastic cells in stabilized CSF samples from newly diagnosed aggressive B-cell non-Hodgkin's lymphoma (B-NHL) at high risk of CNS relapse, using a prospective, multicentric study design. Moreover, we compared the distribution of different subpopulations of CSF leukocytes and the clinico-biologic characteristics of CSF+ versus CSF-, patients, in an attempt to define new algorithms useful for predicting CNS disease. Overall, 27 (22%) of 123 patients showed infiltration by FCM, while CC was positive in only seven patients (6%), with three other cases being suspicious (2%). CC+/FCM+ samples typically had more than 20% neoplastic B cells and/or >or= one neoplastic B cell/microL, while FCM+/CC- samples showed lower levels (P < .0001) of infiltration. Interestingly, in Burkitt lymphoma, presence of CNS disease by FCM could be predicted with a high specificity when increased serum beta2-microglobulin and neurological symptoms coexisted, while peripheral blood involvement was the only independent parameter associated with CNS disease in diffuse large B-cell lymphoma, with low predictive value. FCM significantly improves the sensitivity of CC for the identification of leptomeningeal disease in aggressive B-NHL at higher risk of CNS disease, particularly in paucicellular samples.
Journal of Clinical Oncology, 2006
The optimal postremission therapy for children with very high-risk (VHR) acute lymphoblastic leuk... more The optimal postremission therapy for children with very high-risk (VHR) acute lymphoblastic leukemia (ALL) is not well established. This randomized trial compared three options of postremission therapy: chemotherapy and allogeneic or autologous stem-cell transplantation (SCT). All 106 VHR-ALL patients received induction with five drugs followed by intensification with three cycles of chemotherapy. Patients in complete remission (CR) with an HLA-identical family donor were assigned to allogeneic SCT (n = 24) and the remaining were randomly assigned to autologous SCT (n = 38) or to delayed intensification followed by maintenance chemotherapy up to 2 years in CR (n = 38). Overall, 100 patients achieved CR (94%). With a median follow-up of 6.5 years, 5-year disease-free survival (DFS) and overall survival (OS) probabilities were 45% (95% CI, 37% to 54%) and 48% (95% CI, 40% to 57%), respectively. The three groups were comparable in the main pretreatment ALL characteristics. Intention-to-treat analysis showed no differences for donor versus no donor in DFS (45%; 95% CI, 27% to 65% v 45%; 95% CI, 37% to 55%) and OS (48%; 95% CI, 30% to 67% v 51%; 95% CI, 43% to 61%), as well as for autologous SCT versus chemotherapy comparisons (DFS: 44%; 95% CI, 29% to 60% v 46%; 95% CI, 32% to 62%; OS: 45%; 95% CI, 31% to 62% v 57%; 95% CI, 43% to 73%). No differences were found within the different subgroups of ALL and neither were differences observed when the analysis was made by treatment actually performed. This study failed to prove that, when a family donor is available, allogeneic SCT produces a better outcome than autologous SCT or chemotherapy in children with VHR-ALL.
International Journal of Hematology, 2007
Intrathecal (IT) depot liposomal cytarabine is useful in solid tumors or lymphomatous meningitis,... more Intrathecal (IT) depot liposomal cytarabine is useful in solid tumors or lymphomatous meningitis, but has scarcely been used in central nervous system (CNS) involvement in acute leukemia. We report the results of compassionate therapy with IT depot liposomal cytarabine in 10 patients with acute myeloid leukemia with CNS involvement. Five of 6 cases receiving this drug as the only IT therapy and the remaining 4 receiving it as adjuvant therapy to other CNS-directed therapies showed clearance of cerebrospinal fluid blast cells, with sustained response in 5 and mild side effects. Systemic therapy was given concomitantly in all cases, with high-dose cytarabine in 6. Clinical trials should establish the role of IT liposomal cytarabine in leukemic meningitis.
European Journal of Haematology, 2010
Flow cytometry (FCM) analysis of cerebrospinal fluid (CSF) is more sensitive than conventional cy... more Flow cytometry (FCM) analysis of cerebrospinal fluid (CSF) is more sensitive than conventional cytology (CC) for diagnosis of lymphomatous meningeosis, but the clinical significance of occult central nervous system (CNS) disease (positive FCM with negative CC) remains unknown. CSF samples from 105 patients with newly diagnosed aggressive lymphomas at high risk of CNS involvement were prospectively studied by both CC and FCM, and results were correlated with cumulative incidence of CNS relapse and overall survival (OS). Patients were divided into three groups: 1) patients without CNS involvement (CC-/FCM-; n=83); 2) individuals with occult CNS disease (FCM+/CC-; n=15); and 3) cases with CNS disease (CC+/FCM+; n=7). Six cases showed CNS relapse or progression: two in Group 1 (2.4%), two in Group 2 (13%) and two in Group 3 (28.5%) (Group 2 vs. 1, P=0.04; Group 3 vs. 1, P<0.001). Patients from Groups 2 (P=0.05) and 3 (P<0.001) also showed a higher cumulative incidence of CNS relapse than those from Group 1. Significant differences were observed in OS between FCM-/CC- and FCM+/CC+ cases (P=0.02), while patients with occult CNS disease (FCM+/CC-) displayed intermediate OS rates, although differences did not reach statistical significance. The presence of occult CNS involvement at diagnosis in patients with NHL at high risk of CNS disease is associated with a higher probability of CNS relapse.
British Journal of Haematology, 2001
Of 167 newly diagnosed acute promyelocytic leukaemia patients, 83 patients were long (L)-form (50... more Of 167 newly diagnosed acute promyelocytic leukaemia patients, 83 patients were long (L)-form (50%), eight variable (V)-form (5%) and 76 short (S)-form (45%). The V-form and S-form groups presented a significantly higher percentage of patients with white blood cell counts . 10 Â 10 9 /l (P , 0´05). The S-form cases displayed a significantly higher number of cases with M3v microgranular features (P 0´005) and CD34 expression (P , 0´0001). There were no differences between the three isoforms in complete remission (CR) rate (overall CR 90%), but the 3-year disease-free survival was lower for Vform cases than it was for L-and S-form cases (62% vs. 94% and 89%, P 0´056). We conclude that the V-form and Sform types are associated with some negative prognostic features at diagnosis. However, our data were only able to demonstrate an association with adverse prognosis in the Vform type and, moreover, as the number of cases was limited, needs to be confirmed in large, uniformly treated series.
Blood, 2010
Few studies have examined the outcome of large numbers of patients with the microgranular variant... more Few studies have examined the outcome of large numbers of patients with the microgranular variant (M3V) of acute promyelocytic leukemia (APL) in the all-trans retinoic acid era. Here, the outcome of 155 patients treated with all-trans retinoic acid-based therapy on 3 clinical trials, North American Intergroup protocol I0129 and Programa para el Estudio de la Terapéutica en Hemopatía Maligna protocols LPA96 and LPA99, are reported. The complete remission rate for all 155 patients was 82%, compared with 89% for 748 patients with classical M3 disease. The incidence of the APL differentiation syndrome was 26%, compared with 25% for classical M3 patients, and the early death rate was 13.6% compared with 8.4% for patients with classical M3 morphology. With a median follow-up time among survivors of 7.6 years (range 3.6-14.5), the 5-year overall survival, disease-free survival, and cumulative incidence of relapse for patients with M3V were 70%, 73%, and 24%, respectively. With a median follow-up time among survivors of 7.6 years (range 0.6-14.3), the 5-year overall survival, disease-free survival, and cumulative incidence of relapse among patients with classical M3 morphology were 80% (P = .006 compared with M3V), 81% (P = .07), and 15% (P = .005), respectively. When outcomes were adjusted for the white blood cell count or the relapse risk score, none of these outcomes were significantly different between patients with M3V and classical M3 APL.
British Journal of Haematology, 2005
Blood, 2004
Therapeutic results in elderly patients with acute promyelocytic leukemia (APL) have been general... more Therapeutic results in elderly patients with acute promyelocytic leukemia (APL) have been generally reported as less effective than for younger patients. Patients 60 years or older with APL who were enrolled in 2 successive multicenter PETHEMA studies received induction therapy with all-trans retinoic acid (ATRA) and idarubicin, consolidation with 3 anthracycline monochemotherapy courses with or without ATRA, and maintenance with ATRA and low-dose chemotherapy. Eighty-seven of 104 patients achieved complete remission (84%). Eightysix proceeded to consolidation therapy (2 withdrew after the first and second courses). Deaths in remission occurred during consolidation and maintenance therapy in 3 and 4 patients, respectively. One patient showed molecular persistence after consolidation and 5 had a relapse. The 6-year cumulative incidence of relapse, leukemia-free survival, and disease-free survival were 8.5%, 91%, and 79%, respectively. A significantly higher incidence of low-risk patients found among the elderly, as compared to younger patients, may partially account for the low relapse rate observed. This study confirms the high antileukemic efficacy, low toxicity, and high degree of compliance of protocols using ATRA and anthracycline monochemotherapy for induction and consolidation therapy in elderly patients.
Actas Dermo-Sifiliográficas, 2003
... Manuel Almagroa, Jesús del Pozoa, Jesús García-Silvaa, María Teresa Yebra-Pimentelb, Guillerm... more ... Manuel Almagroa, Jesús del Pozoa, Jesús García-Silvaa, María Teresa Yebra-Pimentelb, Guillermo Debenc y ... Paul C, Giachetti S, Pinquier L, Flageul B, Dubertret L, Calvo F. Cutaneous effects ... Fariña MC, Requena L, Dómine M, Soriano ML, Estévez L, Barat A. Histopathology ...
Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis, 2010
Between 30% and 60% of patients with thrombotic thrombocytopenic purpura (TTP) relapse and mortal... more Between 30% and 60% of patients with thrombotic thrombocytopenic purpura (TTP) relapse and mortality remains at 15-20%. Limited clinical data suggest that the administration of anti-CD20 antibody (rituximab) may be useful in preventing acute refractory and chronic relapsing TTP.
Blood, 2006
Introduction: CC analysis of the CSF is considered as the reference method to diagnose meningeal ... more Introduction: CC analysis of the CSF is considered as the reference method to diagnose meningeal disease in patients with B-NHL. However, recent studies suggest that in patients with B-NHL who are at high risk of CNS relapse, FCM could be more sensitive than CC for detecting meningeal disease in CSF. Objective: To evaluate the sensitivity and specificity of a standardized FCM immunophenotypic approach vs CC for detecting the presence of neoplastic cells in CSF, in patients with aggressive B-NHL who are at high risk of CNS relapse. Patients and methods: A total of 29 CSF samples were analysed (total volume: 0.8 to 4ml; median: 2.4) in newly diagnosed patients with aggressive B-NHL, from a total of 14 different hospitals (diffuse large B cell lymphoma-DLBCL: 17; Burkitt’s lymphoma-BL: 9; follicular lymphoma transformed to DLBCL -tFL: 2; and T-cell-rich B-NHL: 1). Of the 29 patients studied, 15 were men (52%) and 14 women (48%) with a mean age of 55 ± 19 years (range: 16–86). In all ca...
Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren, 1989
Archivos de bronconeumología, 2004
The most common cause of Pancoast syndrome is bronchogenic carcinoma. Other less common causes ar... more The most common cause of Pancoast syndrome is bronchogenic carcinoma. Other less common causes are solid tumor metastases, other chest tumors, infections, and hematologic neoplasms. Pancoast syndrome due to lymphoma is very rare, and cases described in the literature are essentially associated with non-Hodgkin lymphomas. In a review of the literature we found a single case of Pancoast syndrome secondary to a Hodgkin lymphoma; however, the syndrome manifested during recurrence of disease in that patient. We report a case of nodular sclerosis Hodgkin lymphoma which first manifested clinically as Pancoast syndrome and which was initially diagnosed by bronchial biopsy.
RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 1989
Journal of Clinical Oncology, 2010
We analyzed the incidence, risk factors, and outcome of therapy-related myeloid neoplasms (t-MNs)... more We analyzed the incidence, risk factors, and outcome of therapy-related myeloid neoplasms (t-MNs) in patients with acute promyelocytic leukemia (APL) in first complete remission (CR). From 1996 to 2008, 1,025 patients with APL were enrolled onto three sequential trials (LPA96, LPA99, and LPA2005) of the Programa Español para el Tratamiento de Enfermedades Hematológicas and received induction and consolidation therapy with all-trans-retinoic acid (ATRA) and anthracycline-based chemotherapy. Seventeen of 918 patients who achieved CR developed t-MN (10 with < 20% and seven with…
Journal of Clinical Oncology, 2009
Here, we evaluate the sensitivity and specificity of a new 11-parameter flow cytometry (FCM) appr... more Here, we evaluate the sensitivity and specificity of a new 11-parameter flow cytometry (FCM) approach versus conventional cytology (CC) for detecting neoplastic cells in stabilized CSF samples from newly diagnosed aggressive B-cell non-Hodgkin's lymphoma (B-NHL) at high risk of CNS relapse, using a prospective, multicentric study design. Moreover, we compared the distribution of different subpopulations of CSF leukocytes and the clinico-biologic characteristics of CSF+ versus CSF-, patients, in an attempt to define new algorithms useful for predicting CNS disease. Overall, 27 (22%) of 123 patients showed infiltration by FCM, while CC was positive in only seven patients (6%), with three other cases being suspicious (2%). CC+/FCM+ samples typically had more than 20% neoplastic B cells and/or >or= one neoplastic B cell/microL, while FCM+/CC- samples showed lower levels (P < .0001) of infiltration. Interestingly, in Burkitt lymphoma, presence of CNS disease by FCM could be predicted with a high specificity when increased serum beta2-microglobulin and neurological symptoms coexisted, while peripheral blood involvement was the only independent parameter associated with CNS disease in diffuse large B-cell lymphoma, with low predictive value. FCM significantly improves the sensitivity of CC for the identification of leptomeningeal disease in aggressive B-NHL at higher risk of CNS disease, particularly in paucicellular samples.
Journal of Clinical Oncology, 2006
The optimal postremission therapy for children with very high-risk (VHR) acute lymphoblastic leuk... more The optimal postremission therapy for children with very high-risk (VHR) acute lymphoblastic leukemia (ALL) is not well established. This randomized trial compared three options of postremission therapy: chemotherapy and allogeneic or autologous stem-cell transplantation (SCT). All 106 VHR-ALL patients received induction with five drugs followed by intensification with three cycles of chemotherapy. Patients in complete remission (CR) with an HLA-identical family donor were assigned to allogeneic SCT (n = 24) and the remaining were randomly assigned to autologous SCT (n = 38) or to delayed intensification followed by maintenance chemotherapy up to 2 years in CR (n = 38). Overall, 100 patients achieved CR (94%). With a median follow-up of 6.5 years, 5-year disease-free survival (DFS) and overall survival (OS) probabilities were 45% (95% CI, 37% to 54%) and 48% (95% CI, 40% to 57%), respectively. The three groups were comparable in the main pretreatment ALL characteristics. Intention-to-treat analysis showed no differences for donor versus no donor in DFS (45%; 95% CI, 27% to 65% v 45%; 95% CI, 37% to 55%) and OS (48%; 95% CI, 30% to 67% v 51%; 95% CI, 43% to 61%), as well as for autologous SCT versus chemotherapy comparisons (DFS: 44%; 95% CI, 29% to 60% v 46%; 95% CI, 32% to 62%; OS: 45%; 95% CI, 31% to 62% v 57%; 95% CI, 43% to 73%). No differences were found within the different subgroups of ALL and neither were differences observed when the analysis was made by treatment actually performed. This study failed to prove that, when a family donor is available, allogeneic SCT produces a better outcome than autologous SCT or chemotherapy in children with VHR-ALL.
International Journal of Hematology, 2007
Intrathecal (IT) depot liposomal cytarabine is useful in solid tumors or lymphomatous meningitis,... more Intrathecal (IT) depot liposomal cytarabine is useful in solid tumors or lymphomatous meningitis, but has scarcely been used in central nervous system (CNS) involvement in acute leukemia. We report the results of compassionate therapy with IT depot liposomal cytarabine in 10 patients with acute myeloid leukemia with CNS involvement. Five of 6 cases receiving this drug as the only IT therapy and the remaining 4 receiving it as adjuvant therapy to other CNS-directed therapies showed clearance of cerebrospinal fluid blast cells, with sustained response in 5 and mild side effects. Systemic therapy was given concomitantly in all cases, with high-dose cytarabine in 6. Clinical trials should establish the role of IT liposomal cytarabine in leukemic meningitis.
European Journal of Haematology, 2010
Flow cytometry (FCM) analysis of cerebrospinal fluid (CSF) is more sensitive than conventional cy... more Flow cytometry (FCM) analysis of cerebrospinal fluid (CSF) is more sensitive than conventional cytology (CC) for diagnosis of lymphomatous meningeosis, but the clinical significance of occult central nervous system (CNS) disease (positive FCM with negative CC) remains unknown. CSF samples from 105 patients with newly diagnosed aggressive lymphomas at high risk of CNS involvement were prospectively studied by both CC and FCM, and results were correlated with cumulative incidence of CNS relapse and overall survival (OS). Patients were divided into three groups: 1) patients without CNS involvement (CC-/FCM-; n=83); 2) individuals with occult CNS disease (FCM+/CC-; n=15); and 3) cases with CNS disease (CC+/FCM+; n=7). Six cases showed CNS relapse or progression: two in Group 1 (2.4%), two in Group 2 (13%) and two in Group 3 (28.5%) (Group 2 vs. 1, P=0.04; Group 3 vs. 1, P<0.001). Patients from Groups 2 (P=0.05) and 3 (P<0.001) also showed a higher cumulative incidence of CNS relapse than those from Group 1. Significant differences were observed in OS between FCM-/CC- and FCM+/CC+ cases (P=0.02), while patients with occult CNS disease (FCM+/CC-) displayed intermediate OS rates, although differences did not reach statistical significance. The presence of occult CNS involvement at diagnosis in patients with NHL at high risk of CNS disease is associated with a higher probability of CNS relapse.
British Journal of Haematology, 2001
Of 167 newly diagnosed acute promyelocytic leukaemia patients, 83 patients were long (L)-form (50... more Of 167 newly diagnosed acute promyelocytic leukaemia patients, 83 patients were long (L)-form (50%), eight variable (V)-form (5%) and 76 short (S)-form (45%). The V-form and S-form groups presented a significantly higher percentage of patients with white blood cell counts . 10 Â 10 9 /l (P , 0´05). The S-form cases displayed a significantly higher number of cases with M3v microgranular features (P 0´005) and CD34 expression (P , 0´0001). There were no differences between the three isoforms in complete remission (CR) rate (overall CR 90%), but the 3-year disease-free survival was lower for Vform cases than it was for L-and S-form cases (62% vs. 94% and 89%, P 0´056). We conclude that the V-form and Sform types are associated with some negative prognostic features at diagnosis. However, our data were only able to demonstrate an association with adverse prognosis in the Vform type and, moreover, as the number of cases was limited, needs to be confirmed in large, uniformly treated series.
Blood, 2010
Few studies have examined the outcome of large numbers of patients with the microgranular variant... more Few studies have examined the outcome of large numbers of patients with the microgranular variant (M3V) of acute promyelocytic leukemia (APL) in the all-trans retinoic acid era. Here, the outcome of 155 patients treated with all-trans retinoic acid-based therapy on 3 clinical trials, North American Intergroup protocol I0129 and Programa para el Estudio de la Terapéutica en Hemopatía Maligna protocols LPA96 and LPA99, are reported. The complete remission rate for all 155 patients was 82%, compared with 89% for 748 patients with classical M3 disease. The incidence of the APL differentiation syndrome was 26%, compared with 25% for classical M3 patients, and the early death rate was 13.6% compared with 8.4% for patients with classical M3 morphology. With a median follow-up time among survivors of 7.6 years (range 3.6-14.5), the 5-year overall survival, disease-free survival, and cumulative incidence of relapse for patients with M3V were 70%, 73%, and 24%, respectively. With a median follow-up time among survivors of 7.6 years (range 0.6-14.3), the 5-year overall survival, disease-free survival, and cumulative incidence of relapse among patients with classical M3 morphology were 80% (P = .006 compared with M3V), 81% (P = .07), and 15% (P = .005), respectively. When outcomes were adjusted for the white blood cell count or the relapse risk score, none of these outcomes were significantly different between patients with M3V and classical M3 APL.