{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:04:55Z","timestamp":1781877895085,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2011,11,17]],"date-time":"2011-11-17T00:00:00Z","timestamp":1321488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Therapy\u2010related acute promyelocytic leukemia (t\u2010APL) is a well\u2010recognized form of APL for which the underlying etiology has been well characterized. The pathogenesis of <jats:italic>de novo<\/jats:italic> (dn\u2010APL) remains unknown; but epidemiologic studies have consistently identified increased body mass index (BMI), younger age, and ethnicity as possible risk factors. We analyzed demographics, clinical features, and treatment responses in a contemporary series of 64 patients treated with all\u2010<jats:italic>trans<\/jats:italic>\u2010retinoic acid and anthracycline\u2010based therapy to assess for differences in these two etiologically distinct patient groups. Compared with patients with t\u2010APL (<jats:italic>n<\/jats:italic>\u2003=\u200311), those with dn\u2010APL (<jats:italic>n<\/jats:italic>\u2003=\u200353) had a greater median BMI (31.33 vs. 28.48), incidence of obesity (60.4% vs. 27.3%) (<jats:italic>P\u2003=<\/jats:italic>\u20030.04), and history of hyperlipidemia (45.3% vs. 18.2%) (<jats:italic>P\u2003=<\/jats:italic>\u20030.01). Fewer t\u2010APL than dn\u2010APL patients achieved complete remission at 63.6% vs. 92.5% respectively (<jats:italic>P\u2003=<\/jats:italic>\u20030.008). This was the result of a higher induction mortality rate of 36.4% vs. 7.5% respectively (<jats:italic>P\u2003=<\/jats:italic>\u20030.008). No cases of leukemic resistance were seen in either group. Overall survival (OS) was inferior in t\u2010APL compared with dn\u2010APL at 51% vs. 84%, respectively (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.005), primarily as a result of higher induction mortality. Relapse occurred in nine patients (16.1%) overall, but no relapses occurred in the t\u2010APL cohort. Our observations provide further support for the hypothesis that abnormalities in lipid homeostasis may in some way be of pathogenic importance in dn\u2010APL. Therapy\u2010related APL is sensitive to standard therapy with no cases of resistance or relapse seen. The inferior OS of the t\u2010APL was due to induction mortality, possibly reflecting prior therapy.<\/jats:p>","DOI":"10.1111\/j.1600-0609.2011.01727.x","type":"journal-article","created":{"date-parts":[[2011,10,24]],"date-time":"2011-10-24T13:22:39Z","timestamp":1319462559000},"page":"237-243","source":"Crossref","is-referenced-by-count":25,"title":["Therapy\u2010related acute promyelocytic leukemia: observations relating to APL pathogenesis and therapy*"],"prefix":"10.1111","volume":"88","author":[{"given":"Michelle A.","family":"Elliott","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Letendre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayalew","family":"Tefferi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William 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