Talha Badar, Hematologist/Oncologist at Mayo Clinic in Jacksonville, Florida, shared a post on X:

“Weekend review

Outcome of relapsed APL

Generally, with ATO+ATRA induction CR up 90%, long-term OS 70-80%

Relapses are less common, prior ATO may led to resistance(Zhu NEJM 2014), no clear consensus on auto vs allo-HCT

Brief salvage therapy for relapse APL and outcome

61 pts, Prior Rx ATRA (90%) and ATO (15%); 51% received ATO+ATRA combination, CR rates was 92%, medain OS was 32 vs 164 months with ATRA+ATO salvage.

No additional survival with auto or allo-HCT in pts who Rx with ATRA+ATO

Sasaki et al. CLML 2024

In another study of 52 pts for Korea, 41 received Rx (30 ATO, 11 conventional Rx).

Outcomes were better with ATO salvage therapy with no additional benefit of allo-HCT in improving survival.

Study from India on 67 relapse APL, who were Rx, ~ 29% had CNS relapses. All pts Rx upfront ATO

ATO+ATRA based Rx, 94% achieved molecular remission

4.5% died during re-induction

55% auto-SCT

5 yrs OS 73.6%; 90% with auto and 59% without

Another study on 71 pts from East Asia with long follow up of 94 months.

20% had CNS relapse

Salvage therapy was ATRA+ATO+Ida, pt with CNS disease received IT chemo.

SCT was not done in CR2. 10 yrs LFS was 56.8%.

Italian study on 22 Relapse APL pts, Rx with ATRA+ATO, 91% achieved molecular CR.

One each had auto and allo-HCT.

4 yrs DFS and OS: 74% and 85

Summary Slide!

Source: Talha Badar/X