16 augustus 2011: ik ben kanker-actueel aan het herzien en ik wil u nogmaals wijzen op onderstaand artikel. ATRA - all-trans-retinoicid acid is nog steeds een uitstekend aanvullend middel bij vormen van leukemie. Lees onderstaand studie abstract.  

18 augustus 2005: Blood. 2005 Jul 15;106(2):447-53. Epub 2005 Jan 27.

Nieuwe deelstudie uit veel grotere gerandomiseerde studie (deelstudie resultaat behelst 121 kinderen jonger dan 18 jaar) bewijst dat de combinatie behandeling van all-trans retinoic acid - ATRA - en de chemo idarubicin een significant beter resultaat geeft (96% complete remissie) dan alleen ATRA bij kinderen met APL = Acute Promyelotische Leukemie. De overall overleving en ziektevrije tijd (EFS) was 89% (95% confidence interval [c.i.]: 83%-95%) en 76% (c.i.: 65%-85%), respectievelijk, na meer dan 10 jaar. Hier het abstract van de studie zoals deze maand gepubliceerd in BLOOD

GIMEMA-AIEOPAIDA protocol for the treatment of newly diagnosed acute promyelocytic leukemia (APL) in children.

Testi AM, Biondi A, Lo Coco F, Moleti ML, Giona F, Vignetti M, Menna G, Locatelli F, Pession A, Barisone E, De Rossi G, Diverio D, Micalizzi C, Arico M, Basso G, Foa R, Mandelli F.
Dipartimento di Biotecnologie Cellulari ed Ematologia, Universita La Sapienza, Via Benevento 6, 00161 Rome, Italy. testi@bce.uniroma1.it

The role of all-trans retinoic acid (ATRA) in pediatric acute promyelocytic leukemia (APL) is the topic of several ongoing studies. The results of the Italian pediatric experience with the multicentric Gruppo Italiano per le Malattie Ematologiche dell'Adulto (GIMEMA)-Italian Pediatric Hematology and Oncology Group (AIEOP) "AIDA" (ATRA and idarubicin) trial are presented. Of the 983 patients with APL enrolled in this protocol between January 1993 and June 2000, 124 (13%) had younger than 18 years. Treatment consisted of ATRA and idarubicin induction followed by 3 polychemotherapy consolidation courses. Molecular response by reverse transcriptase-polymerase chain reaction (RT-PCR) was assessed after consolidation and patients who were PCR- were randomized for different maintenances. One hundred and seven children were eligible and evaluable for induction: 103 (96%) achieved a hematologically complete remission. Overt ATRA syndrome was observed in 2 patients and pseudotumor cerebri was observed in 10 patients. Ninety-four patients were evaluable for RT-PCR analysis at the end of consolidation: 91 (97%) proved PCR+ and 3 PCR-. The overall survival and event-free survival (EFS) are 89% (95% confidence interval [c.i.]: 83%-95%) and 76% (c.i.: 65%-85%), respectively, at more than 10 years. A white blood cell (WBC) count at diagnosis of greater than 10 x 10(9)/L had a significant impact on EFS (59% vs 83% at 10 years). These results highlight the efficacy and feasibility of the AIDA protocol in the pediatric APL population.

PMID: 15677559 [PubMed - in process]


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