Incidence and Outcome of ATRA Syndrome in APL Treated With ATRA
| Authors . | No. of Patients . | Prophylaxis of ATRA Syndrome . | No. of ATRA Syndrome (%) . | Treatment of ATRA Syndrome . | Outcome of ATRA Syndrome . | Overall Incidence of Fatal ATRA Syndrome (%) . | |
|---|---|---|---|---|---|---|---|
| CR (%) . | Death (%) . | ||||||
| Fenaux15 (APL 91 trial) | 54 | Chemotherapy added if —WBC >5,000/μL at diagnosis —WBC >6,000, 10,000, 15,000/μL by days 5, 10 and 15 of ATRA, respectively | 6 (11) | Symptomatic | 100 | 0 | 0 |
| Kanamaru18 | 109 | Chemotherapy added if —WBC >3,000/μL at diagnosis —Circulating blasts >1,000/μL during treatment | 7 (6) | DXM: 3 cases | ND | 14 | 1 |
| Vahdat30 | 78 | No prophylaxis | 21 (27) | DXM: leukaphereses chemotherapy | 72 | 28 | 7 |
| Wiley31 | 22 | —if WBC <1,000/μL initially: oral prednisone —if WBC >1,000/μL —if WBC >1,000/μL initially: chemotherapy | 2 (9) | ½ | ½ | 4 | |
| Avvisatti32 | 20 | Chemotherapy in all patients | 2 (10) | DXM | ½ | ½ | 5 |
| Tallmann33 | 172 | Hydroxyurea if —WBC >1,000/μL at diagnosis —WBC >30,000/μL with ATRA | 47 (27) | DXM | ND | 7 | 1 |
| Cortes36 | 17 | Chemotherapy added if circulating blasts + promyelocytes >10,000/μL at diagnosis or increase with ATRA | 4 (24) | Chemotherapy leukaphereses | ¾ | ¼ | 5 |
| Present study (APL93 Trial) | 413 | Same as APL 91 trial | 64 (15) | DXM | 89 | 8 | 1 |
| Authors . | No. of Patients . | Prophylaxis of ATRA Syndrome . | No. of ATRA Syndrome (%) . | Treatment of ATRA Syndrome . | Outcome of ATRA Syndrome . | Overall Incidence of Fatal ATRA Syndrome (%) . | |
|---|---|---|---|---|---|---|---|
| CR (%) . | Death (%) . | ||||||
| Fenaux15 (APL 91 trial) | 54 | Chemotherapy added if —WBC >5,000/μL at diagnosis —WBC >6,000, 10,000, 15,000/μL by days 5, 10 and 15 of ATRA, respectively | 6 (11) | Symptomatic | 100 | 0 | 0 |
| Kanamaru18 | 109 | Chemotherapy added if —WBC >3,000/μL at diagnosis —Circulating blasts >1,000/μL during treatment | 7 (6) | DXM: 3 cases | ND | 14 | 1 |
| Vahdat30 | 78 | No prophylaxis | 21 (27) | DXM: leukaphereses chemotherapy | 72 | 28 | 7 |
| Wiley31 | 22 | —if WBC <1,000/μL initially: oral prednisone —if WBC >1,000/μL —if WBC >1,000/μL initially: chemotherapy | 2 (9) | ½ | ½ | 4 | |
| Avvisatti32 | 20 | Chemotherapy in all patients | 2 (10) | DXM | ½ | ½ | 5 |
| Tallmann33 | 172 | Hydroxyurea if —WBC >1,000/μL at diagnosis —WBC >30,000/μL with ATRA | 47 (27) | DXM | ND | 7 | 1 |
| Cortes36 | 17 | Chemotherapy added if circulating blasts + promyelocytes >10,000/μL at diagnosis or increase with ATRA | 4 (24) | Chemotherapy leukaphereses | ¾ | ¼ | 5 |
| Present study (APL93 Trial) | 413 | Same as APL 91 trial | 64 (15) | DXM | 89 | 8 | 1 |
Abbreviation: ND, not done.