Early mortality and overall survival in acute promyelocytic leukemia: do real-world data match results of the clinical trials?

Prajwal Dhakal, Elizabeth Lyden, Venkat Rajasurya, Amer M. Zeidan, Chakra Chaulagain, Krishna Gundabolu, Vijaya Raj Bhatt

Research output: Contribution to journalArticlepeer-review

Abstract

Acute promyelocytic leukemia (APL) boasts overall survival (OS) of >90% at 3 years and early mortality of <5% in recent clinical trials. Using a large National Cancer Database, we performed analysis of 7190 adults with APL to determine whether one-month mortality and OS of patients with APL treated in real-world practices mirror outcomes noted in clinical trials. Only 64% of total patients received multi-agent therapy; 32% received either single-agent therapy or no therapy at all. One-month mortality was 6% for patients ≤18 years, 6% for 19–40 years, 10% for 41–60 years, and 21% for >60 years. OS at 1- and 3-year were 81% and 75%, respectively. In a multivariate analysis, age ≤ 40 years, treatment at academic center, use of multi-agent therapy, and diagnosis after 2009 conferred better OS. In this largest database study in APL till date, we demonstrated an overall improvement in OS over time but challenges still exist in translating successes of clinical trials to real-world practices.

Original languageEnglish (US)
JournalLeukemia and Lymphoma
DOIs
StateAccepted/In press - 2021

Keywords

  • Acute promyelocytic leukemia
  • clinical trials
  • leukemia
  • older adults
  • one-month mortality
  • overall survival

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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