It has been said that you don’t always know what you have until it’s gone. This admonition certainly does not apply to our friend and colleague Dr. Francesco Lo Coco whose sudden death on March 3, 2019, has stunned the hematology community. We all know exactly what we had. He was a warm, inspiring, clear thinking, collaborative academic clinician focused on advancing our understanding of the biology, pathogenesis, and treatment of acute promyelocytic leukemia (APL).
Dr. Lo Coco was Professor of Medicine at the University of Rome Tor Vergata where he was Head of the Integrated Diagnostic Laboratory. Such a position reflected his particular interest in deciphering the molecular and genetic features of a variety of hematologic malignancies. However, his name is most closely associated with APL. He was completely immersed in the study and treatment of this rare yet fascinating subtype of acute myeloid leukemia. His insights and contributions were many. He was the co-chair of a series of international symposiums on APL held every four years in Rome starting in 1993. He was a founding member of the International Consortium on APL (IC-APL), an initiative supported by ASH, which began in 2004 as an endeavor to improve the care and outcome for patients with APL in less developed countries. He published hundreds of manuscripts addressing a wide range of topics in APL, both in the form of original research and reviews, which demonstrated the breadth of his interests and achievements. Perhaps his most important accomplishment is the introduction of chemotherapy-free treatment for low-risk APL with all-trans retinoic acid (ATRA) and arsenic. This approach changed the standard of care and results in a cure rate of 98 percent of patients. Such a strategy serves as a model for the targeted treatment of other hematologic malignancies.
Dr. Lo Coco was an active member of ASH, serving on the International Members Committee as well as contributing a significant amount of time as Editor-in-Chief of the Italian edition of Blood. He served on the editorial boards of several other prestigious journals including the Journal of Clinical Oncology and Leukemia. He chaired the Education Committee of the European Hematology Association and was president of the Italian Society of Hematology. Dr. Lo Coco was a frequent and skilled educator, lecturing at numerous important meetings on acute leukemias around the world. He always discussed APL in a clear and authoritative way as he conveyed his wealth of experience in the disease. As focused as he was in APL, Dr. Lo Coco made many contributions in other hematologic malignancies as well. He leaves an important legacy of scholarly contributions from which both clinicians and patients will benefit for many years to come.
Nothing enlivened Dr. Lo Coco more than talking about APL, except one person: his son Gaetano. He was exceptionally proud of Gaetano, a gifted, young orchestra conductor. No surprise. The apple never falls far from the tree.
— Martin S. Tallman, MD, Chief, Leukemia Service, Memorial Sloan Kettering Cancer Center; Professor of Medicine, Weill Cornell Medical College, New York, NY