The impact of medical education and networking on the outcome of leukemia treatment in developing countries. the experience of International Consortium on Acute Promyelocytic Leukemia (IC-APL)

The impact of medical education and networking on the outcome of leukemia treatment in developing countries. the experience of International Consortium on Acute Promyelocytic Leukemia (IC-APL)

Author Rego, Eduardo M. Google Scholar
Kim, Haesook T. Google Scholar
Ruiz-Argueelles, Guillermo J. Google Scholar
del Rosario Uriarte, Maria Google Scholar
Jacomo, Rafael H. Google Scholar
Gutierrez-Aguirre, Homero Google Scholar
Melo, Raul A. M. Google Scholar
Bittencourt, Rosane Google Scholar
Pasquini, Ricardo Google Scholar
Pagnano, Katia Google Scholar
Fagundes, Evandro M. Google Scholar
Chauffaille, Maria de Lourdes Autor UNIFESP Google Scholar
Chiattone, Carlos Google Scholar
Martinez, Lem Google Scholar
Meillon, Luis A. Google Scholar
Gomez-Almaguer, David Google Scholar
Kwaan, Hau Google Scholar
Garces-Eisele, Javier Google Scholar
Gallagher, Robert Google Scholar
Niemeyer, Charlotte M. Google Scholar
Lowenberg, Bob Google Scholar
Ribeiro, Raul Google Scholar
LoCoco, Francesco Google Scholar
Sanz, Miguel A. Google Scholar
Institution Universidade de São Paulo (USP)
Dana Farber Canc Inst
Clin Ruiz de Puebla
Asociac Espanola Primera Socorros Mutuos
Univ Hosp
Univ Fed Rio Grande do Sul
Univ Fed Parana
Universidade Estadual de Campinas (UNICAMP)
Universidade Federal de Minas Gerais (UFMG)
Universidade Federal de São Paulo (UNIFESP)
Santa Casa Med Sch
Ctr Med Nacl Siglo XXI
Northwestern Univ
Albert Einstein Canc Ctr
Univ Med Ctr
Erasmus Univ
St Jude Childrens Rsch Hosp
Univ Roma Tor Vergata
Hosp Univ La Fe
Abstract Objectives: Several clinical trials conducted in Europe and US reported favorable outcomes of patients with APL treated with the combination of all trans retinoic acid (ATRA) and anthracyclines. Nevertheless, the results observed in developing countries with the same regimen was poorer, mainly due to high early mortality mainly due bleeding. the International Consortium on Acute Promyelocytic Leukemia (IC-APL) is an initiative of the International Members Committee of the ASH and the project aims to reduce this gap through the establishment of international network, which was launched in Brazil, Mexico and Uruguay.Methods: the IC-APL treatment protocol is similar to the PETHEMA 2005, but changing idarubicin to daunorubicin. All patients with a suspected diagnosis of APL were immediately started on ATRA, while bone marrow samples were shipped to a national central lab where genetic verification of the diagnosis was performed. the immunofluorescence using an anti-PML antibody allowed a rapid confirmation of the diagnosis and, the importance of supportive measures was reinforced.Results: the interim analysis of 97 patients enrolled in the IC-APL protocol showed that complete remission (CR) rate was 83% and the 2-year overall survival and disease-free survival were 80% and 90%, respectively. of note, the early mortality rate was reduced to 7.5%.Discussion: the results of IC-APL demonstrate the impact of educational programs and networking on the improvement of the leukemia treatment outcome in developing countries.
Keywords Acute promyelocytic leukemia
Developing countries
All trans retinoic acid
Language English
Date 2012-04-01
Published in Hematology. Leeds: Maney Publishing, v. 17, p. S36-S38, 2012.
ISSN 1024-5332 (Sherpa/Romeo, impact factor)
Publisher Maney Publishing
Extent S36-S38
Access rights Closed access
Type Article
Web of Science ID WOS:000302916200011

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