Relapses or death of 13 APL patients in CR1 receiving maintenance treatment with oral As2O3
| UPN . | Sex . | Age, y . | Presentation . | Peak WBC during induction treatment . | APL differentiation syndrome . | Maintenance . | First site of relapse . | Event (time) . | Treatment and outcome . | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Hemoglobin, g/dL . | WBC, × 109/L . | Platelets, × 109/L . | |||||||||
| Relapse | |||||||||||
| 5 | M | 44 | 7.0 | 5.1 | 26 | 90.0 | Yes | A | Marrow | Relapse (20 mo) | CR2 with AAA, 3 subsequent CNS relapses at 36 mo, 68 mo, 89 mo; re-treated with AAA + RT and IT chemotherapy to CR3, died of systemic relapse at 100 mo |
| 10 | M | 42 | 11.0 | 1.2 | 162 | 4.0 | No | A | Marrow | Relapse (11 mo) | CR2 with AAA, died of pulmonary embolism at 16 mo |
| 19 | M | 44 | 9.9 | 1.7 | 7 | 22.3 | No | A | Marrow | Relapse (12 mo) | CR2 with AAA, third systemic and CNS relapse at 30 mo, also developed salivary gland carcinoma, died of APL at 37 mo |
| 24 | M | 58 | 8.6 | 19.8 | 78 | 33.2 | No | AA | Marrow | Relapse (27 mo)* | CR2 with AAA, CNS relapse at 52 mo, CR3 with AAA + IT + RT + chemotherapy, in CR3 at 66+ mo |
| 37 | M | 49 | 8.0 | 2.4 | 13 | 61.1 | Yes | AA | CNS and marrow | Relapse (27 mo)* | CR2 with AAA + RT + chemotherapy, 43+ mo |
| 43 | M | 42 | 7.9 | 121.0 | 19 | 123.0 | Yes | AAA | CNS | Relapse (0 mo)† | CR2 with IT + chemotherapy + RT, 34+ mo |
| 56 | M | 39 | 3.3 | 1.0 | 8 | 1.1 | No | AAA | Marrow | Relapse (11 mo) ‡ | CR2 with AAA, 20+ mo |
| 22 | F | 40 | 9.5 | 0.7 | 51 | 6.7 | No | AA | Molecular | Mo relapse (55 mo) | CR2 with AAA, 15+ mo |
| Death | |||||||||||
| 1 | M | 72 | 9.7 | 1.0 | 123 | 2.0 | No | A | Death (89 mo) | Died of colon cancer in CR1, also had history of mantle cell lymphoma | |
| 2 | F | 73 | 5.4 | 0.3 | 62 | 4.0 | No | A | Death (62 mo) | Died of a stroke, in CR1 | |
| 12 | F | 44 | 8.0 | 1.2 | 82 | 1.7 | Yes | A | Death (33 mo) | Died of nasopharyngeal cancer, in CR1 | |
| 41 | F | 47 | 6.4 | 6.8 | 39 | 35.0 | No | AAA | Death (18 mo) | Died of colon cancer, in CR1 | |
| 69 | F | 53 | 8.8 | 0.8 | 14 | 9.2 | No | AAA | Death (4 mo) | Died of disseminated breast cancer predating the diagnosis of APL, in CR1 | |
| UPN . | Sex . | Age, y . | Presentation . | Peak WBC during induction treatment . | APL differentiation syndrome . | Maintenance . | First site of relapse . | Event (time) . | Treatment and outcome . | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Hemoglobin, g/dL . | WBC, × 109/L . | Platelets, × 109/L . | |||||||||
| Relapse | |||||||||||
| 5 | M | 44 | 7.0 | 5.1 | 26 | 90.0 | Yes | A | Marrow | Relapse (20 mo) | CR2 with AAA, 3 subsequent CNS relapses at 36 mo, 68 mo, 89 mo; re-treated with AAA + RT and IT chemotherapy to CR3, died of systemic relapse at 100 mo |
| 10 | M | 42 | 11.0 | 1.2 | 162 | 4.0 | No | A | Marrow | Relapse (11 mo) | CR2 with AAA, died of pulmonary embolism at 16 mo |
| 19 | M | 44 | 9.9 | 1.7 | 7 | 22.3 | No | A | Marrow | Relapse (12 mo) | CR2 with AAA, third systemic and CNS relapse at 30 mo, also developed salivary gland carcinoma, died of APL at 37 mo |
| 24 | M | 58 | 8.6 | 19.8 | 78 | 33.2 | No | AA | Marrow | Relapse (27 mo)* | CR2 with AAA, CNS relapse at 52 mo, CR3 with AAA + IT + RT + chemotherapy, in CR3 at 66+ mo |
| 37 | M | 49 | 8.0 | 2.4 | 13 | 61.1 | Yes | AA | CNS and marrow | Relapse (27 mo)* | CR2 with AAA + RT + chemotherapy, 43+ mo |
| 43 | M | 42 | 7.9 | 121.0 | 19 | 123.0 | Yes | AAA | CNS | Relapse (0 mo)† | CR2 with IT + chemotherapy + RT, 34+ mo |
| 56 | M | 39 | 3.3 | 1.0 | 8 | 1.1 | No | AAA | Marrow | Relapse (11 mo) ‡ | CR2 with AAA, 20+ mo |
| 22 | F | 40 | 9.5 | 0.7 | 51 | 6.7 | No | AA | Molecular | Mo relapse (55 mo) | CR2 with AAA, 15+ mo |
| Death | |||||||||||
| 1 | M | 72 | 9.7 | 1.0 | 123 | 2.0 | No | A | Death (89 mo) | Died of colon cancer in CR1, also had history of mantle cell lymphoma | |
| 2 | F | 73 | 5.4 | 0.3 | 62 | 4.0 | No | A | Death (62 mo) | Died of a stroke, in CR1 | |
| 12 | F | 44 | 8.0 | 1.2 | 82 | 1.7 | Yes | A | Death (33 mo) | Died of nasopharyngeal cancer, in CR1 | |
| 41 | F | 47 | 6.4 | 6.8 | 39 | 35.0 | No | AAA | Death (18 mo) | Died of colon cancer, in CR1 | |
| 69 | F | 53 | 8.8 | 0.8 | 14 | 9.2 | No | AAA | Death (4 mo) | Died of disseminated breast cancer predating the diagnosis of APL, in CR1 | |
Regimen A indicates As2O3; Regimen AA, ATRA + As2O3; Regimen AAA, ATRA + As2O3 + ascorbic acid; CR1, first complete remission; CR2, second complete remission; IT, intrathecal chemotherapy; RT, cranial radiotherapy; M, male; F, female; and mo, molecular.
Relapse after cessation of 24 months of maintenance.
Relapse discovered on referral.
Confessed to poor compliance with maintenance drugs.