1. Delay in the administration of all-trans retinoic acid and its effects on early mortality in acute promyelocytic leukemia: Final results of a multicentric study in the United States
- Author
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Armin Rashidi, Nadine S. Aguilera, Stephen I. Fisher, Farzaneh Sayedian, Teresa A. Goldin, Michael G. Bayerl, Jeffrey A. Vos, Ranjit K. Goudar, and Meghan P. Riley
- Subjects
Adult ,Male ,Patient Transfer ,Acute promyelocytic leukemia ,Cancer Research ,medicine.medical_specialty ,Retinoic acid ,Antineoplastic Agents ,Tretinoin ,Early death ,Time-to-Treatment ,Cohort Studies ,chemistry.chemical_compound ,Patient Admission ,Leukemia, Promyelocytic, Acute ,Internal medicine ,Humans ,Medicine ,neoplasms ,Aged ,Disseminated intravascular coagulation ,business.industry ,organic chemicals ,All trans ,Hematology ,Disseminated Intravascular Coagulation ,Middle Aged ,medicine.disease ,Survival Analysis ,United States ,Icu admission ,Surgery ,Leukemia ,Oncology ,chemistry ,Female ,business - Abstract
Early death (ED) occurs in 10–30% of patients with acute promyelocytic leukemia (APL). Is all-trans retinoic acid (ATRA) promptly given and does it decrease overall early mortality? ATRA was administered within 24 h of morphological suspicion in only 44% of the 120 consecutive patients treated in the four collaborating centers. Absence of disseminated intravascular coagulation (p = 0.012) and admission to a non-university-affiliated hospital (p = 0.032) were independent predictors of ATRA delay. ED occurred in 17% of patients, and was independently correlated only with ICU admission (p = 0.002). Our results do not demonstrate that prompt (versus delayed) ATRA administration decreases overall early death.
- Published
- 2014