An analysis of the impact of CD56 expression in de novo acute promyelocytic leukemia patients treated with upfront all-trans retinoic acid and anthracycline-based regimens
Por:
Sobas, M, Montesinos, P, Boluda, B, Bernal, T, Vellenga, E, Nomdedeu, J, Gonzalez-Campos, J, Chillon, M, Holowiecka, A, Esteve, J, Bergua, J, Gonzalez-Sanmiguel, J, Gil-Cortes, C, Tormo, M, Salamero, O, Manso, F, Fernandez, I, de la Serna, J, Moreno, M, Perez-Encinas, M, Krsnik, I, Ribera, J, Escoda, L, Lowenberg, B, Sanz, M, de Heredia, J, Hernandez, J, Arias, J, Ramos, F, Roman, A, Negri, S, Rayon, C, Fernandez-Calvo, F, Diaz-Mediavilla, J, Gil, C, Olave, M, Amutio, E, Pedro, C, Gorosquieta, A, Viguria, M, Zudaire, M, Molero, T, Sayas, M, Guardia, R, Esquembre, C, Garcia, R, Alcala, A, Lopez, J, Rubio, V, Amigo, M, Linares, M, San Miguel, J, Coruna, A, Deben, G, de la Camara, R, Molines, A, Loureiro, C, Allegue, M, Amador, L, Marti, J, Madero, L, Lassaletta, A, Cabezudo, M, Garcia-Larana, J, Rojas, R, Ortega, F, Penarrubia, M, Puente, F, Lopez-Ibor, B, Brunet, S, Ibanez, J, Sanchez, P, Novo, A, Guinea, J, Montero, A, Gonzalez, M, Martin, G, Martinez, J, Verdeguer, A, Garcia, P, Conde, E, Garcia, J, Capote, F, Bueno, J, Bastida, P, Rubio, A, Fuster, J, Gonzalez, J, Perez, I, Molina, J, Mateos, M, Ardaiz, M, Rodriguez-calvillo, M, Poderos, C, Arnan, M, Duarte, R, Diaz-Morfa, M, Martin-Chacon, E, Calvo-Villas, J, Garcia-Belmonte, D, Hernandez-Maraver, D, Ossenkoppele, G, van der Lelie, J, Sonneveld, P, Zijlmans, M, Maertens, J, de Valk, B, Wijermans, P, de Groot, M, Schouten, H, Biesma, D, van Marwijk, M, de Lisa, E, Golos, A, Ejduk, A, Armatys, A, Zarzycka, E, Knopinska, W, Miskiewicz, W, Jastrzab, B, Pluta, A, Paluszewska, M, Podhorecka, M, Gromek, T, Jakubas, B, Majcherek, M, Skret, A, Watek, M, Charlinski, G, Calbecka, M, Becht, R, Gadomska, A, Rzenno, E, Piszcz, J, Grosicki, S, Palmer, L, Ciarlo, S, Bezares, F, Rojas, F, Longoni, H, Gelemur, M, Fazio, P, Canepa, C, Saba, S, Balladares, G, Negri, P, Giunta, M, Milone, J, Lafalse, D, Sossa, C, Jaramillo, F, Mayer, J, Protivankova, M, Scwarz, J, PETHEMA Cooperative Grp, HOVON Cooperative Grp, PALG Cooperative Grp and GATLA Cooperative Grp
Publicada:
21 mar 2019
Resumen:
Out of 956, there were 95 (10%) CD56+ APL patients treated with PETHEMA ATRA and chemotherapy. CD56+ expression was associated with high WBC, BCR3 isoform, and co-expression of CD2, CD34, CD7, HLA-DR, CD15, and CD117 antigens. CD56+ vs CD56- APL presented higher induction death rate (16% vs 8%, p = .02) and 5-years cumulative incidence of relapse (33% versus 10%, p = .006), irrespectively of the Sanz score (low-risk 47% versus 5%, p < .001; intermediate 23% versus 7%, p < .001; and high-risk 42% versus 21%, p = .007). In the multivariate analysis, CD56 + (p < .0001), higher relapse-risk score (p = .001), and male gender (p = .05) retained the independent predictive value. CD56+ APL also showed a greater risk of CNS relapse (6% versus 1%, p < .001) and lower 5-year OS (75% versus 83%, p = .003). The AIDA-based LPA2012 trial, with an intensified consolidation schedule for CD56+ APL, will elucidate whether an intensified consolidation schedule could mitigate the relapse rate in this setting.
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