ATRA and anthracycline-based chemotherapy in the treatment of childhood acute promyelocytic leukemia (APL): A 10-year experience in Tunisia.

Ramzi Jeddi (1) , Hèlà Ghédira (1) , Yosr Ben Abdennebi (2) , Karima Kacem (2) , Ramzi Ben Amor (2) , Lamia Aissaoui (2) , Walid Bouterâa (2) , Raihane Ben Lakhal (2) , Hèla Ben Abid (2) , Samia Menif (3) , Zaher Belhadjali (1) , Balkis Meddeb (1)

1 Hematology Department
2 Hematology Department
3 Institut Pasteur de Tunis

Reports on childhood APL from developing countries are scarce. We treated 65 APL with two consecutive trials combining ATRA and chemotherapy. Twenty (30.7%) were aged less than 20 years including 11 girls and 9 boys, with a median age of 12 years. Fever at presentation (P = 0.002) and variant APL (P = 0.044) were more frequent in children, while there were no significant difference between children and adults for WBC count, Sanz's score distribution and additional cytogenetic abnormalities. The CR rate was 95% (19/20) in children and 80% (36/45) in adults (P = 0.13). Differentiation syndrome (DS) was less often observed in children (1/20) than in adults (13/45) (P = 0.031). Two children relapsed and died during salvage therapy, and 2 died in CR from infection and from cardiac failure attributed to anthracyclines, while other children remained alive in CR. With a median follow-up of 4 years, 4-year EFS was 75% in children and 71.1% in adults (P = 0.57), while 4-year OS was 75% in children vs. 73.3% in adults (P = 0.72). Our results suggest that, even in the absence of optimal socio-economic condition, ATRA combined with anthracycline-based chemotherapy gives adequate results in childhood APL, as in adults.

Domaines: Hématologie

Ramzi Jeddi, Hèlà Ghédira, Yosr Ben Abdennebi, Karima Kacem, Ramzi Ben Amor, et al.. ATRA and anthracycline-based chemotherapy in the treatment of childhood acute promyelocytic leukemia (APL): A 10-year experience in Tunisia.. Medical oncology and tumor pharmacotherapy, 2011, 28 (4), pp.1618-23. ⟨10.1007/s12032-010-9642-9⟩. ⟨pasteur-00646596⟩