A RECENT clinical trial has found that using a standardised treatment algorithm, alongside expert support, significantly reduces early mortality in patients with acute promyelocytic leukaemia (APL). This nonrandomised study, conducted between 2017 and 2021, involved 201 patients across 43 centres, including both academic and community hospitals.
APL, a rare and aggressive form of leukaemia, has a historically high early mortality rate, with up to 30% of patients dying within the first month due to complications like infections and bleeding. However, the trial showed that by using a treatment algorithm focused on supportive care and offering 24/7 expert guidance from seven APL specialists, the one-month mortality rate dropped to just 3%.
The results were significant: six patients out of 201 died within the first month, resulting in a one-month survival rate of 97% and a one-year survival rate of 94.5%. These findings suggest that implementing a standardised, expert-supported treatment approach could greatly improve survival in APL, especially in community hospitals with limited access to specialised care. The authors recommend expanding such support systems to enhance outcomes nationwide.
Helena Bradbury, EMJ
Reference
Jillella AP et al. Academic community partnership in acute promyelocytic leukemia and early mortality: The ECOG-ACRIN EA9131 trial. JAMA Oncol. 2025; doi:10.1001/jamaoncol.2024.7033.
