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Author Notes:

Anand P. Jillella, MD, Georgia Cancer Center at Augusta University, BAA 5409, 1120 15th St, Augusta, GA 30912; e-mail: ajillella@augusta.edu

Conception and design: Anand P. Jillella, Martha L. Arellano, Amy A. Langston, Morgan L. McLemore, Chao Zhang, Asad Bashey, Robert K. Stuart, Vamsi K. Kota Administrative support: Prachi Karkhanis, Shruthi H. Krishnamurthy, Sheldon L. Bolds Provision of study material or patients: Anand P. Jillella, Martha L. Arellano, Manila Gaddh, Amy A. Langston, Leonard T. Heffner, Elliott F. Winton, Morgan L. McLemore, Chao Zhang, Jose Tongol, Mohamed M. El Geneidy, Asim Pati, Jonathan M. Gerber,Michael R. Grunwald, Jorge Cortes, Asad Bashey, Robert K. Stuart, Vamsi K. Kota Collection and assembly of data: Manila Gaddh, Sheldon L. Bolds, Stephanie DeBragga, Prachi Karkhanis, Shruthi H. Krishnamurthy, Jose Tongol, Vamsi K. Kota Data analysis and interpretation: Anand P. Jillella, Martha L. Arellano, Manila Gaddh, Amy A. Langston, Morgan L. McLemore, Chao Zhang, Kathryn S. Simon, Sheldon L. Bolds, Prachi Karkhanis, Jose Tongol, Jonathan M. Gerber, Michael R. Grunwald, Jorge Cortes, Asad Bashey, Robert K. Stuart Manuscript writing: All authors Final approval of manuscript: All authors Accountable for all aspects of the work: All authors

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Research Funding:

Cephalon (Inst)

Chimerix (Inst), Astellas Pharma (Inst), Incyte (Inst), Takeda Pharmaceuticals (Inst), Jazz Pharmaceuticals (Inst), Kadmon (Inst), Novartis (Inst)

Pharmacyclics (Inst), Genentech (Inst), Kite Pharma (Inst), ADC Therapeutics (Inst), Astex Pharmaceuticals (Inst)

Incyte, Sierra Oncology, Samus Therapeutics, Blueprint Medicines

Janssen Pharmaceuticals (Inst), FORMA Therapeutics (Inst), Incyte (Inst), Genentech (Inst), Roche (Inst)

Bristol Myers Squibb (Inst), Novartis (Inst), Pfizer (Inst), Astellas Pharma (Inst), Immunogen (Inst), Sun Pharma (Inst), Takeda Pharmaceuticals (Inst), Merus (Inst), Daiichi Sankyo (Inst), Tolero Pharmaceuticals (Inst), Trovagene (Inst), Jazz Pharmaceuticals (Inst)

Ono Pharmaceutical, Agios, Astellas Pharma

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • TRANS-RETINOIC ACID
  • EARLY DEATH RATE
  • ARSENIC TRIOXIDE
  • CLINICAL-FEATURES
  • RECEIVED ATRA
  • UNITED-STATES
  • SURVIVAL
  • OUTCOMES
  • THERAPY
  • CONSOLIDATION

Comanagement Strategy Between Academic Institutions and Community Practices to Reduce Induction Mortality in Acute Promyelocytic Leukemia

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Journal Title:

JCO ONCOLOGY PRACTICE

Volume:

Volume 17, Number 4

Publisher:

, Pages E497-E505

Type of Work:

Article | Final Publisher PDF

Abstract:

PURPOSE Acute promyelocytic leukemia (APL) is a curable leukemia with . 90% survival in clinical trials. Population-based studies from Sweden and US SEER data have shown long-term survival rates of 62% and 65.7%, with the lower rate being from a higher percentage of early deaths. METHODS In this prospective, multicenter trial, we developed a simplified algorithm that focused on prevention and early treatment of the three main causes of death: bleeding, differentiation syndrome, and infection. All patients with a diagnosis of APL were included. The initial 6 months were spent educating oncologists about early deaths in APL. At the time of suspicion of an APL, an expert was contacted. The algorithm was made available followed by discussion of the treatment plan. Communication between expert and treating physician was frequent in the first 2 weeks, during which time most deaths take place. RESULTS Between September 2013 and April 2016, 120 patients enrolled in the study from 32 hospitals. The median age was 52.5 years, with 39% . 60 years and 25% with an age-adjusted Charlson comorbidity index . 4. Sixty-three percent of patients were managed at community centers. Two patients did not meet the criteria for analysis, and of 118 evaluable patients, 10 died, with an early mortality rate of 8.5%. With a median follow-up of 27.3 months, the overall survival was 84.5%. CONCLUSION Induction mortality can be decreased and population-wide survival improved in APL with the use of standardized treatment guidelines. Support from experts who have more experience with induction therapy is crucial and helps to improve the outcomes.

Copyright information:

© 2020 by American Society of Clinical Oncology

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/rdf).
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