Evidence map›Paper›PMID 37380920›Full record

ArticleIndian journal of pediatrics2024

Treatment of Pediatric Acute Promyelocytic Leukemia with Retinoic Acid and Arsenic Trioxide along with Chemotherapy.

Shyam Srinivasan, Chetan Dhamne, Nirmalya Roy Moulik, Akanksha Chichra, Prashant Tembhare, Nikhil Patkar, P G Subramanian, Dhanlaxmi Shetty, Gaurav Narula, Shripad Banavali

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Article in Indian journal of pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Shyam SrinivasanDepartment of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, 400012, India.
Chetan DhamneDepartment of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, 400012, India. chetandhamne@gmail.com.ORCID 0000-0002-3637-2880
Nirmalya Roy MoulikDepartment of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, 400012, India.
Akanksha ChichraDepartment of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, 400012, India.
Prashant TembhareDepartment of Hematopathology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Homi Bhabha National Institute, Mumbai, India.
Nikhil PatkarDepartment of Hematopathology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Homi Bhabha National Institute, Mumbai, India.
P G SubramanianDepartment of Hematopathology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Homi Bhabha National Institute, Mumbai, India.
Dhanlaxmi ShettyDepartment of Cancer Cytogenetics, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Homi Bhabha National Institute, Mumbai, India.
Gaurav NarulaDepartment of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, 400012, India.
Shripad BanavaliDepartment of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, 400012, India.
Homi Bhabha National Institute · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesOutcomes of childhood acute promyelocytic leukemia (APL) have exceeded 90% in the era of differentiating agents. In resource-limited settings, early mortality secondary to coagulopathy remains a significant challenge. Differentiation syndrome is a unique complication of APL therapy that requires a high degree of suspicion for timely initiation of therapy.

methodsA retrospective study of children ≤15 y of age with APL diagnosed between January-2013 and June-2019 treated at a tertiary cancer centre was conducted. Patients with a total leukocyte count ≥10,000/µL were risk stratified as high-risk. Treatment included differentiating agents, all-trans retinoic acid and arsenic trioxide along with chemotherapy. Baseline demographics, clinical complications and outcomes were analysed.

resultsOut of 90 patients treated, 48 (53%) had high-risk APL and 25 (28%) presented with significant bleeding manifestations. Response to therapy was excellent with 96% of evaluable patients achieving molecular remission by the end of consolidation phase. Differentiation syndrome occurred in 23 (25%) patients of which two expired. Early mortality rate was 5.5% and was due to severe hemorrhage most often at the time of presentation. The 3-y overall survival of the entire cohort was 91% (95% CI: 85-97%). Two of 4 patients with relapse of disease could be salvaged with only differentiating agents followed by autologous transplantation.

conclusionsLong-term outcomes of Indian children with APL are excellent. Timely management of coagulopathy and prompt initiation of differentiating agents along with appropriate cytoreductive measures is critical. Efforts to build academic-community partnerships to ensure timely diagnosis and emergency care in order to reduce early mortality are needed.

Indexed as

Arsenic TrioxideLeukemia, Promyelocytic, AcuteTretinoinAdolescentAntineoplastic Combined Chemotherapy ProtocolsChildChild, PreschoolFemaleHumansInfantMaleRetrospective StudiesArsenic TrioxideTretinoinAcute promyelocytic leukemiaDifferentiation syndromeEarly mortalityIndiaSurvival

Identifiers

PMID37380920
OpenAlexW4382501602

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.