It begins with a tendency to bruising, nosebleeds, bleeding gums, fatigue, weight loss and loss of appetite. It is acute promyelocytic leukemia (Apl), an aggressive form of acute myeloid leukemia that has benefited most from progress linked to personalized therapy. And the traditional update event on the disease organized by the Gimema Foundation – Franco Mandelli onlus (Italian group of adult hematological diseases) is dedicated precisely to Apl, this year a scientific event of an international nature, but also an opportunity to celebrate one of the most important successes of hematological research.
During the 8th international symposium on APL, which will be held in Rome on 10 and 11 April – a note informs – Italian and international hematologists (coming from Germany, Sweden, Australia, China and Spain), together with representatives of the most important companies scientific experts, will meet at the Hotel NH Collection Roma Centro to discuss the latest frontiers to be overcome in the treatment of patients affected by this blood cancer and to honor the memory of Professor Francesco Lo Coco, who passed away prematurely and was involved since the early 1990s in the APL study and author of fundamental studies on the subject.
During the two days, the results of international studies on high-risk forms of APL and pediatric APL will be presented, on the problems relating to real-life treatment and on the role of allogeneic transplantation. Scientific progress in the study of the biology of the disease will then be illustrated. Furthermore, during the thematic sessions the speakers will discuss the questions still open and the new therapies with arsenic in tablets whose results, once validated, may allow the use of a totally oral therapy, which is especially important for cycles consolidation treatments currently administered in the clinic.
Acute promyelocytic leukemia – the note recalls – is the form of acute myeloid leukemia that has benefited most from the progress linked to personalized therapy. In fact, starting from the identification of the chromosomal translocation t (15;17), which occurred in 1977, and from the evidence that all-trans retinoic acid (Atra) was able to induce remission of the disease, this pathology has become one of the paradigms of the success of molecularly targeted therapies in tumors.
“Italian hematology and in particular Professor Lo Coco contributed greatly to this success – states Maria Teresa Voso, professor of Hematology at the University Hospital of Rome Tor Vergata and scientific coordinator of the event – Starting from the Aida therapeutic scheme of 2006, which associated all-trans retinoic acid with the chemotherapy idarubicin, the results of the Gimema cooperative group on the treatment of Apl culminated in the revolutionary therapy based on Atra and arsenic (Ato), without chemotherapy, whose effectiveness was demonstrated in the Gimema study APL0406, published in 2013 in the New England Journal of Medicine”.
Atra-Ato has thus become “the standard therapy for low-intermediate risk promyelocytic leukemia – continues Voso – responding positively to the question 'Acute Promyelocytic Leukemia, a curable disease?', title of the first international symposium, held in Rome in 1993, and became in subsequent editions the main theater for updating and discussing the issues still open in Apl. Today the probability of recovery of Apl reaches 90% in normal clinical practice”, highlights the specialist. A “path of Italian excellence – adds Marco Vignetti, president of the Gimema Foundation – which in the next congress on Apl will illustrate the state of the art on the disease, without the question mark anymore: Apl, a curable disease”.
The symposium – continues the note – will be followed on 12 April by the second Gimema national meeting, during which the protagonists of Gimema research will update doctors and haematological researchers from all over Italy on the ongoing research activities, studies and projects carried out by the research groups. work (working party). “The meeting – comments Vignetti – is a moment dedicated to sharing and discussing the most advanced projects for early diagnosis, monitoring and therapy of blood cancers and not only that, but also of non-neoplastic hematological pathologies”.
When it comes to access to care guaranteed in a homogeneous way, “Gimema is at the forefront – assures Vignetti – The protocols are similar in any center and, if a center does not have adequate resources, it makes use of the resources of the most advanced centres, without that the patient has to move from his residence. It is a real model of what online healthcare can offer, for now based on the availability of healthcare workers, doctors, biologists, nurses of our National Health Service. Disseminate, disseminate and raise awareness the public of news in this field can represent a great direct service to Italian citizens, often frightened by the difficulties and shortcomings of the NHS, to make them aware of the high quality of assistance they can receive (among the first in the world) and, above all, to direct them correctly to the right places, without the need for healthcare migrations which, in the field of hematology, are almost never practically necessary”.
The three events are organized thanks to the support of Ail – Italian Association against Leukemia, Lymphoma and Myeloma, Ail Rome, Ail Bari, Italian Society of Hematology (Sie), European Hematology Association (Eha), Ministry of University and Research and with the non-conditioning contribution of AbbVie, Amgen, Novartis, Astellas, AstraZeneca, Briston Myers Squibb, Roche, Incyte, Jazz Pharmaceuticals and Servier Italia.
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