2021, Number 3
<< Back
Rev Cubana Hematol Inmunol Hemoter 2021; 37 (3)
Hepatic evaluation in patients with promyelocytic leukemia treated with the LPM-TOA protocol
Hernández PC, González RM, Quintero SY, Concepción FY, Romero GA, Macia PI, Borges MY
Language: Spanish
References: 30
Page: 1-15
PDF size: 345.60 Kb.
ABSTRACT
Introduction:
With the LPM-TOA protocol for the treatment of acute promyelocytic leukemia, excellent results are obtained, overall survival is prolonged and the patients are cured, in the induction to remission two drugs are used, an anthracycline and arsenic trioxide, and in consolidation the patients again receive a high dose of arsenic.
Objective:
To assess late liver toxicity in patients with promyelocytic leukemia treated according to the PML-TOA protocol.
Methods:
A prospective longitudinal study was carried out that included 20 patients treated with this protocol, all with more than two years of having suspended treatment. The clinical histories were reviewed and by means of the initial and evolutionary values of liver enzymes, the initial and evolutionary liver function was evaluated and the Ritis index was determined to predict evolution to chronicity if there is liver damage.
Results:
Men and women presented with the same frequency and the mean age for males was 36.39 and for females it was 39, with a standard deviation of ± 14.02 and ± 9.43 respectively. The most frequent morphological variety was hypergranular, the average Ritis index was only 1.006 with a standard deviation of 0.745.
Conclusions:
There was no clinical or enzymatic evidence of late liver toxicity in the patients studied.
REFERENCES
Sanz MA, Grimwade D, Tallman MS, Lowenberg B, Fenaux P, Estey EH, et al. Management of acute promyelocytic Leukemia: recommendations from an expert panel on behalf of the European Leukemia Net. Blood. 2017;113(9):1875-91.
Ablain J. Revisiting the differentiation paradigm in acute promyelocitic leukemia. Blood.2011;117(22):5795-802.
Ramos Peñafiel CO, Castellanos Sinco H, Montaño E, Martínez Murillo C, Lavielle P, García Vidrios V. Experiencia del tratamiento de la leucemia promielocítica aguda (LAP) en el Hospital General de México: protocolo LAP 2001. Rev Hematol Mex. 2009;10(2):57.
Talman MS, Andersen JW, Schiffer CA. Clinical description of 44 patiens with acute promyelocyticleucemia who Developer the retinoic acid syndrome. Blood. 2018;95(1):90-5.
Brown G, Hughes P. Retinoid Differentiation Therapy for Common Types of AcuteMyeloid Leukemia. Leuk Res Treat. 2012;2(01):12.
Shen ZX, Chen GQ, Ni JH, Li XS, Xiong SM, Qiu QY, et al. Use of Arsenic Trioxide (As2O3) in the Treatment of Acute Promyelocytic Leukemia (APL): II. Clinical Efficacy and Pharmacokinetics in Relapsed Patients.Blood. 1997;89(9):3354-60.
Ercilla-Liceaga M, Andueza-Granados K, FernándezGonzález I, Barcia-Romero MJ. El trióxido de arsénico en el tratamiento de la leucemia promielocítica aguda. Rev. Farm Hosp. 2016;27(2):93-100.
Land HJ, Bradstock K, Supple SG, Catalano A, Collins M, Hertzberg M, et al. All-trans-retinoic acid, idarubicin, and IV arsenic trioxide as initial therapy in acute promyelocytic leukemia. Blood. 2017;120(8):1570-80.
Powell BL, Moser B, Stock W, Gallagher RE, Willman CL, Stone RM, et al. Arsenic trioxide improves event-free and overall survival for adults with acute promyelocytic leukemia: North American Leukemia Intergroup Study C9710. Blood. 2018;116(19):3751-7.
Coombs CC, Tavakkoli M, Tallman MS. Acute promyelocytic leukemia: where did we start, where are we now, and the future. Blood Cancer Journal.2015;5:1-9.
Ganzel C, Douer D. Extramedullary disease in APL: a real phenomenon or not? Best Practice & Research Clinical Haematology. 2014;27:63-8.
National Cancer Institute: PDQ(r) Adult Acute Myeloid Leukemia Treatment. Bethesda, MD: National Cancer Institute. [Internet]. 2015 Jul-Sep [acceso 21/05/2020];31(3):323-32. Disponible en: www.cancer.gov/types/leukemia/hp/adult-aml-treatmentpdq.
Hernández Padrón C, Machín García S, Gómez Carril M, Ramón Rodriguez L, Losada Buchillón R, AgramonteLlánes O, et al. Uso del trióxido de arsénico (Arsenin (r)) en el tratamiento de la leucemia promielocítica en recaída. Rev Cubana Hematol Inmunol Hemoter[Internet]. 2007 Abr [acceso 21/05/2020];23(1). Disponible en: http://scielo.sld.cu/scielo.php? script=sci_arttext&pid=S086402892007000100009&lng=es.
Hernández-Padrón C, Dorticós-Balea E, Machín-García S, Menéndez-Veitía A, González-Otero A, Ávila-Cabrera O, et al. Leucemia promielocítica de reciente diagnóstico. Tratamiento con trióxido de arsénico de producción nacional.(ARSENIN(r)). Rev Cubana Hematol Inmunol Hemoter. 2014;30(4):346-59.
Montoya Segura F, Solano C JR. Aminotransferasas (Importancia de las Aminotransferasas y su cociente en Hepatopatías). RevMed de Costa Rica.1980;(470) 3-5: XLVII
Grimwade D, Jovanovic JV, Hills RK, Nugent EA, Patel Y, Flora R, et al. Prospective minimal residual disease monitoring to predict relapse of acute promyelocyticleukaemia and direct pre-emptive arsenic trioxide therapy. J ClinOncol. 2019;27(22):3650.
Ghavamzadeh A, Alimoghaddam K, Rostami S, Ghaffari SH, Jahani M, Iravani M, et al. Phase II study of single-agent arsenic trioxide for the front-line therapy of acute promyelocytic leukemia. J ClinOncol.2015;29(20):2753-7.
Lo-Coco F, Cicconi L, Breccia M. Current standard treatment of adult acute promyelocytic leukemia. BJH.2016;(172):841-54.
Breen KA, Grimwade D, Hunt BJ. The pathogenesis and management of the coagulopathy of acute promyelocyticleukaemia.British Journal of Haematology. 2012;156(1):24-36.
Breccia M, Latagliata R, Cannella L. Early hemorrhagic death before starting therapy in acute promyelocytic leukemia: Association with high WBC count, late diagnosis and delayed treatment initiation. Haematologica.2016;95:853-4.
Sanz MA, MontesinosP. How we prevent and treat differentiation syndrome in patients with acute promyelocytic leukemia. Blood. 2014;123(18):2777-82.
Wang ZY, Chen Z. Acute promyelocyticleucemia: from highly fatal to highly curable. Blood.2017;111(5):2505-15.
Miller W, Schipper H, Lee J, Singer J, Waxman S. Mechanisms of action of arsenic trioxide. Cancer Res. 2002;62:3893-903.
Iland H, Collins M, Bradstock. Use of arsenic trioxide in remission induction and consolidation therapy for APL ALLG APLM.Lancet Haematology.2015;2:357-66.
Burnnet A, Russell N, Hills R, Bowen D, Kell J, Knapper S et al. Arsenic trioxide and all-trans retinoic acid treatment for acute promyelocyticleukaemia in all risk groups (AML17): results of a randomised, controlled, phase 3 trial. LancetOncology. 2015;6:1295-305.
Campos-Cortés A, Nájera-Martínez J, Uriarte-Duque J, García-Castillo C. Trióxido de arsénico en leucemia promielocítica aguda. Rev. SanidMilit Mex. 2016;70:148-51.
Chendamarai E. Role of minimal residual disease monitoring in acute promyelocytic leukemia treated with arsenic trioxide in frontline therapy. Blood. 2012;119(15):3413-9.
Suárez Beyríes L C, Noa Tamayo Y, Rodríguez Reyes I, Hernández GalanoG, de la UzRuesga BO. Tratamiento con trióxido de arsénico en pacientes con leucemia promielocítica aguda. MEDISAN. 2014; 18(1):26.
Niu C, Yan H, Yu T. Studies on treatment of acute promyelocytic lymphoma with arsenic trioxide: remission induction, follow up, and molecular monitoring in 11 newly diagnosed and 47 relapsed acute promyelocytic leukemia patients. Blood 1999; 94: 3315-24.
Mathews V, George B, Lakshmi KM, Viswabandya A, Bajel A, Balasubramanian P. Single-agent arsenic trioxide in the treatment of newly diagnosed acute promyelocytic leukemia: durable remissions with minimal toxicity. Blood. 2006;107(7):2627-32.