The role of allogeneic stem cell transplant in advanced acute promyelocytic leukemia patients who received standard first and second-line therapy is still unknown. We report the outcome of 31 acute promyelocytic leukemia patients (median age 39) who underwent allogeneic transplant in second-remission (15patients) or beyond (16patients. Sixteen patients were RT-PCR positive and 15 negative for PML/RARA pre-transplant. The 4-year overall-survival was 62 % and 31% for patients transplanted in second-remission and beyond, respectively (p=0.05) and 64% and 27% for patients with RT-PCR-negative and positive pre-transplant, respectively (p=0.03). The 4-year cumulative-incidence of relapse was 32% and 44% for patients transplanted in second-remission and beyond, respectively (p=0.37) and 30% and 47% for patients transplanted with negative and positive RT-PCR, respectively (p=0.30). Transplant-related mortality was 19.6%. In conclusion, allogeneic transplant is effective in advanced acute promyelocytic leukemia in the all-trans-retinoic acid and arsenic trioxide era and should be considered once relapse is diagnosed.
Allogeneic stem cell transplantation for advanced acute promyelocytic leukemia in the ATRA and ATO era / SM. Ramadan ; A. Di Veroli ; A.Camboni ; M.Breccia ; AP. Iori; F. Aversa ; L. Cupelli ; C. Papayannidis ; A. Bacigalupo ; W. Arcese ; F. Lo-Coco. - In: HAEMATOLOGICA. - ISSN 0390-6078. - 97:11(2012), pp. 1731-1735. [10.3324/haematol.2013.101279]