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Objective: The obesity/overweight may have an influence on APL outcomes. Methods: This is the biggest multicentre analysis on 1320 APL patients treated with AIDA‐induction and risk‐adapted consolidation between 1996 and 2012. Patients body mass index (BMI) was classified as underweight (<18.5 kg/m2), normal (18.5‐25 kg/m2), overweight (25‐29.9 kg/m2), and obese (≥30 kg/m2) according to the World Health Organization (WHO) criteria. Results and conclusions: Relationship between male gender, older age, and other known laboratory abnormalities in overweight/obese patients was significant. The induction mortality rate was significantly higher in APL with BMI ≥25 vs BMI <25 (10% vs 6%; P =.04). APL patients with BMI ≥25 had a trend to lower OS (74% vs 80%; P =.06). However, in the multivariate analysis, BMI did not retain the independent predictive value (P =.46). There was no higher incidence of differentiation syndrome with BMI ≥25, but there was a trend in obese. There was no difference in relapse rate according to the BMI. In summary, overweight/obesity does not represent an independent risk factor for APL outcomes. The influence of obesity in APL patients treated with chemotherapy‐free regimens remains to be established. [ABSTRACT FROM AUTHOR]

Although additional cytogenetic abnormalities (ACA) do not affect the prognosis of patients with t(15;17) acute promyelocytic leukemia (APL), the role of a complex karyotype (CK) is yet to be clarified. We aimed to investigate the relationship of CK with relapse incidence in 1559 consecutive APL patients enrolled in three consecutive trials. Treatment consisted of AIDA induction followed by risk-adapted consolidation. A CK (CK) was defined as the presence of ≥2 ACA, and a very CK (CK+) as ≥3 ACA. Eighty-nine patients (8%) had a CK, of whom 41 (4%) had CK+. The 5-year cumulative incidence of relapse (CIR) in patients with CK was 18%, and 12% in those with <2 ACA (p=.09). Among patients with CK+, the 5-year CIR was 27% vs 12% (p=.003), retaining the statistical significance in multivariate analysis. This study shows an increased risk of relapse among APL patients with CK + treated with ATRA plus chemotherapy front-line regimens. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]