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Title: Improving acute promyelocytic leukemia (APL) outcome in developing countries through networking, results of the International Consortium on APL
Authors: Rego, Eduardo M.
Kim, Haesook T.
Ruiz-Argueelles, Guillermo J.
Undurraga, Maria Soledad
Uriarte, Maria del Rosario
Jacomo, Rafael H.
Gutierrez-Aguirre, Homero
Melo, Raul A. M.
Bittencourt, Rosane
Pasquini, Ricardo
Pagnano, Katia
Fagundes, Evandro M.
Chauffaille, Maria de Lourdes [UNIFESP]
Chiattone, Carlos S.
Martinez, Lem
Meillon, Luis A.
Gomez-Almaguer, David
Kwaan, Hau C.
Garces-Eisele, Javier
Gallagher, Robert
Niemeyer, Charlotte M.
Schrier, Stanley L.
Tallman, Martin
Grimwade, David
Ganser, Arnold
Berliner, Nancy
Ribeiro, Raul C.
Lo-Coco, Francesco
Loewenberg, Bob
Sanz, Miguel A.
Universidade de São Paulo (USP)
Dana Farber Canc Inst
Clin Ruiz Puebla
Hosp Salvador
Asociac Espanola Primera Socorros Mutuos
Hosp Univ Dr Jose E Gonzalez
Fundacao HEMOPE
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
Stanford Univ
Mem Sloan Kettering Canc Ctr
Kings Coll London Sch Med
Hannover Med Sch
Harvard Univ
St Jude Childrens Res Hosp
Univ Roma Tor Vergata
Santa Lucia Fdn
Erasmus MC
Valencia Univ Med Sch
Issue Date: 14-Mar-2013
Publisher: Amer Soc Hematology
Citation: Blood. Washington: Amer Soc Hematology, v. 121, n. 11, p. 1935-1943, 2013.
Abstract: Thanks to modern treatment with all-trans retinoic acid and chemotherapy, acute promyelocytic leukemia (APL) is now the most curable type of leukemia. However, this progress has not yielded equivalent benefit in developing countries. the International Consortium on Acute Promyelocytic Leukemia (IC-APL) was established to create a network of institutions in developing countries that would exchange experience and data and receive support from well-established US and European cooperative groups. the IC-APL formulated expeditious diagnostic, treatment, and supportive guidelines that were adapted to local circumstances. APL was chosen as a model disease because of the potential impact on improved diagnosis and treatment. the project included 4 national coordinators and reference laboratories, common clinical record forms, 5 subcommittees, and laboratory and data management training programs. in addition, participating institutions held regular virtual and face-to-face meetings. Complete hematological remission was achieved in 153/180 (85%) patients and 27 (15%) died during induction. After a median follow-up of 28 months, the 2-year cumulative incidence of relapse, overall survival (OS), and disease-free survival (DFS) were 4.5%, 80%, and 91%, respectively. the establishment of the IC-APL network resulted in a decrease of almost 50% in early mortality and an improvement in OS of almost 30% compared with historical controls, resulting in OS and DFS similar to those reported in developed countries.
ISSN: 0006-4971
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