Delay in the administration of all-trans retinoic acid and its effects on early mortality in acute promyelocytic leukemia: final results of a multicentric study in the United States

Leuk Res. 2014 Sep;38(9):1036-40. doi: 10.1016/j.leukres.2014.06.011. Epub 2014 Jun 30.

Abstract

Early death (ED) occurs in 10-30% of patients with acute promyelocytic leukemia (APL). Is all-trans retinoic acid (ATRA) promptly given and does it decrease overall early mortality? ATRA was administered within 24h of morphological suspicion in only 44% of the 120 consecutive patients treated in the four collaborating centers. Absence of disseminated intravascular coagulation (p=0.012) and admission to a non-university-affiliated hospital (p=0.032) were independent predictors of ATRA delay. ED occurred in 17% of patients, and was independently correlated only with ICU admission (p=0.002). Our results do not demonstrate that prompt (versus delayed) ATRA administration decreases overall early death.

Keywords: ATRA; Death; Leukemia; Promyelocytic.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / administration & dosage*
  • Cohort Studies
  • Disseminated Intravascular Coagulation / mortality
  • Female
  • Humans
  • Leukemia, Promyelocytic, Acute / drug therapy*
  • Leukemia, Promyelocytic, Acute / mortality*
  • Male
  • Middle Aged
  • Patient Admission / statistics & numerical data
  • Patient Transfer / statistics & numerical data
  • Survival Analysis
  • Time-to-Treatment*
  • Tretinoin / administration & dosage*
  • United States / epidemiology

Substances

  • Antineoplastic Agents
  • Tretinoin