Impact of CD56 Continuously Recognizable as Prognostic Value of Acute Promyelocytic Leukemia: Results of Multivariate Analyses in the Japan Adult Leukemia Study Group (JALSG)-APL204 Study and a Review of the Literature

Cancers

Nobuaki Dobashi¹  Noriko Usui¹  Masamitsu Yanada²  Maki Hagihara³  Masashi Sawa⁴  Hitoshi Kiyoi⁵  Rikio Suzuki⁶  Yasuhiro Taniguchi⁷  Itaru Matsumura⁷  Masaru Nakagawa⁸  Yasushi Miyazaki⁹  Katsumichi Fujimaki^1,10  Shigehisa Tamaki^1,11  Yoshinobu Maeda^1,12  Toru Sakura^1,13  Hiroyuki Fujita^1,14  Hitoshi Minamiguchi^1,15  Yasunori Ueda^1,16  Norio Asou^1,17  the Japan Adult Leukemia Study Group^1,18  Shigeki Ohtake^1,19  Yukio Kobayashi^2,20  Tomoki Naoe^2,21  Yoshiko Atsuta^2,22  Hiroaki Furumaki^2,23  Akihiro Takeshita^2,23 

[1] Clinical Oncology/Hematology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishisinbashi, Minatoku, Tokyo 105-8461, Japan;Hematology and Cell Therapy, Aichi Cancer Center, 1-1 Kanokoden, Chikusaku, Nagoya 464-8681, Japan;Hematology and Clinical Immunology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama 236-0004, Japan;Hematology and Oncology, Anjo Kosei Hospital, 28 Higashikurokute, Anjochou, Anjo 446-8602, Japan;Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumaichou, Showaku, Nagoya 466-8550, Japan;Hematology and Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isahara 259-1193, Japan;Hematology and Rheumatology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Ohsakasayama 589-8511, Japan;Hematology and Rheumatology, Nihon University School of Medicine, 30-1 Ohyaguchikamichou, Itabashiku, Tokyo 173-8610, Japan;Hematology, Atomic Bomb Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan;Hematology, Fujisawa City Hospital, 2-6-1 Fujisawa, Fujisawa 251-8550, Japan;Hematology, Japanese Red Cross Ise Hospital, 1-471-2 Funae, Ise 516-8512, Japan;Hematology, Oncology and Respiratory Medicine, Okayama University Medical School, 2-5-1 Shikatachou, Kitaku, Okayama 700-8558, Japan;Hematology, Saiseikai Maebashi Hospital, 564-1, Kamishindenmachi, Maebashi 371-0821, Japan;Hematology, Saiseikai Yokohama Nanbu Hospital, 3-2-10 Kounandai, Kounanku, Yokohama 234-0054, Japan;Hematology, Shiga University of Medical Science, Seta-Tsukinowa, Otsu 520-2192, Japan;Hematology/Oncology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki 710-8602, Japan;International Medical Center, Saitama Medical University, 1397-1, Yamane, Hidaka 350-1298, Japan;JALSG office, 3-6-35 Nishiki, Nakaku, Nagoya 460-0003, Japan;Kanazawa University, Kakumamachi, Kanazawa 920-1192, Japan;National Cancer Center Hospital, 5-1-1 Tsukiji, Chuouku, Tokyo 104-0045, Japan;National Hospital Organization Nagoya Medical Center, 4-1-1 Sannomaru, Nakaku, Nagoya 460-0001, Japan;The Japanese Data Center for Hematopoietic Cell Transplantation, 1-1-20 Taikou-minami, Higashiku, Nagoya 461-0047, Japan;Transfusion and Cell Therapy, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Higashiku 431-3192, Japan;

关键词: acute promyelocytic leukemia;    prognosis;    multivariate analysis;    tamibarotene;    CD56;   

DOI  :  10.3390/cancers12061444

来源: DOAJ

【 摘 要 】

Background: After long-term analysis of the JALSG-APL204 study we recently reported that maintenance therapy with tamibarotene was more effective than all-trans retinoic acid (ATRA) by reducing relapse in APL patients. Here, the clinical significance of other important prognostic factors was evaluated with multivariate analyses. Patients and Methods: Newly diagnosed acute promyelocytic leukemia (APL) patients were registered with the study. Induction was composed of ATRA and chemotherapy. Patients who achieved molecular remission after consolidation were randomly assigned to maintenance with tamibarotene or ATRA. Results: Of the 344 eligible patients, 319 (93%) achieved complete remission (CR). After completing consolidation, 269 patients underwent maintenance random assignment—135 to ATRA, and 134 to tamibarotene. By multivariate analysis, overexpression of CD56 in blast was an independent unfavorable prognostic factor for relapse-free survival (RFS) (p = 0.006) together with more than 10.0 × 10⁹/L WBC counts (p = 0.001) and the ATRA arm in maintenance (p = 0.028). Of all phenotypes, CD56 was related most clearly to an unfavorable prognosis. The CR rate, mortality rate during induction and overall survival of CD56⁺ APL were not significantly different compared with CD56^- APL. CD56 is continuously an independent unfavorable prognostic factor for RFS in APL patients treated with ATRA and chemotherapy followed by ATRA or tamibarotene maintenance therapy.

【 授权许可】

Unknown