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Type: Artigo
Title: The impact of medical education and networking on the outcome of leukemia treatment in developing countries. The experience of International Consortium on Acute Promyelocytic Leukemia (IC-APL)
Author: Rego, Eduardo M.
Kim, Haesook T.
Ruiz-Argueelles, Guillermo J.
del Rosario Uriarte, Maria
Jacomo, Rafael H.
Gutierrez-Aguirre, Homero
Melo, Raul A. M.
Bittencourt, Rosane
Pasquini, Ricardo
Pagnano, Katia
Fagundes, Evandro M.
Chauffaille, Maria de Lourdes
Chiattone, Carlos
Martinez, Lem
Meillon, Luis A.
Gomez-Almaguer, David
Kwaan, Hau
Garces-Eisele, Javier
Gallagher, Robert
Niemeyer, Charlotte M.
Lowenberg, Bob
Ribeiro, Raul
LoCoco, Francesco
Sanz, Miguel A.
Abstract: Objectives: Several clinical trials conducted in Europe and US reported favorable outcomes of patients with APL treated with the combination of all trans retinoic acid (ATRA) and anthracyclines. Nevertheless, the results observed in developing countries with the same regimen was poorer, mainly due to high early mortality mainly due bleeding. The International Consortium on Acute Promyelocytic Leukemia (IC-APL) is an initiative of the International Members Committee of the ASH and the project aims to reduce this gap through the establishment of international network, which was launched in Brazil, Mexico and Uruguay. Methods: The IC-APL treatment protocol is similar to the PETHEMA 2005, but changing idarubicin to daunorubicin. All patients with a suspected diagnosis of APL were immediately started on ATRA, while bone marrow samples were shipped to a national central lab where genetic verification of the diagnosis was performed. The immunofluorescence using an anti-PML antibody allowed a rapid confirmation of the diagnosis and, the importance of supportive measures was reinforced. Results: The interim analysis of 97 patients enrolled in the IC-APL protocol showed that complete remission (CR) rate was 83% and the 2-year overall survival and disease-free survival were 80% and 90%, respectively. Of note, the early mortality rate was reduced to 7.5%. Discussion: The results of IC-APL demonstrate the impact of educational programs and networking on the improvement of the leukemia treatment outcome in developing countries
Subject: Leucemia
Country: Reino Unido
Editor: Taylor & Francis
Rights: Fechado
Identifier DOI: 10.1179/102453312X13336169155376
Date Issue: 2012
Appears in Collections:HEMO - Artigos e Outros Documentos

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