Acute promyelocytic leukemia historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]
Overview
Historical perspective
- In 1957, Leif Hillestad described acute promyelocytic leukemia as a distinct clinical condition for the first time. He noted the syndrome of low fibrinogen levels, fibrin degradation, and life-threatening hemorrhage. It was noted that this condition carried a high mortality rate due to severe hemorrhage.[1]
- In 1973, clinical studies showed the therapeutic efficacy of daunorubicin, an chemotherapy agent of the anthracycline class. This medication was shown to induce remission in the majority of patients, with an increase in remission rate from 13% to 58%. The median duration of remission with daunorubicin was more than 2 years. Compared to 6-mercaptopurine, daunorubicin was shown to reduce mortality from bleeding after 5 days.[1]
- In the early 1990s, it was noted that arsenic trioxide could induce remission in a high proportion of patients.[1]
- In 1995, D. Head and colleagues showed that higher remission rates and higher survival rates could be achieved with higher doses of daunorubicin, with a survival rate of 61% after 9 years and a 0% relapse after 36 months.[2]
- In 2013, LoCoco and colleagues showed that, in a randomized phase 3 multicenter clinical trial, a non-chemotherapy-based regimen was superior to a chemotherapy-based regimen for low-risk acute promyelocytic leukemia.[3] Specifically, the combination of all-trans retinoic acid and arsenic trioxide resulted in improved overall survival compared to the combination of all-trans retinoic acid plus chemotherapy. This landmark clinical trial, which was conducted by the Italian and German-Austrian Leukemia Study Groups, altered the treatment paradigm for low-risk acute promyelocytic leukemia.[3]
References
- ↑ 1.0 1.1 1.2 Coombs CC, Tavakkoli M, Tallman MS (2015). "Acute promyelocytic leukemia: where did we start, where are we now, and the future". Blood Cancer J. 5: e304. doi:10.1038/bcj.2015.25. PMC 4450325. PMID 25885425.
- ↑ Head D, Kopecky KJ, Weick J, Files JC, Ryan D, Foucar K; et al. (1995). "Effect of aggressive daunomycin therapy on survival in acute promyelocytic leukemia". Blood. 86 (5): 1717–28. PMID 7655004.
- ↑ 3.0 3.1 Lo-Coco F, Avvisati G, Vignetti M, Thiede C, Orlando SM, Iacobelli S; et al. (2013). "Retinoic acid and arsenic trioxide for acute promyelocytic leukemia". N Engl J Med. 369 (2): 111–21. doi:10.1056/NEJMoa1300874. PMID 23841729.