By Charlotte Niemeyer, MD, Universitaets–Kinderklinik, Freiburg, Germany
Through participation in the International Consortium on Acute
Promyelocytic Leukemia (IC-APL), Uruguayan hematologists have had better
coordination on a national level, revitalized their hematology society, and
started collaborating on a national registry for all hematologic malignancies,
not solely APL, according to Dr. Lem Martinez, the Uruguayan national
coordinator for the IC-APL, during a 2009 IC-APL meeting.
Dr. Martinez’s comments underscore the many benefits of
participation in a network such as the IC-APL. Initiated by ASH in December
2004, the IC-APL facilitates a network of clinicians and researchers in
emerging countries. Its aims are to improve clinical care and to create the
infrastructure for ongoing clinical trials and translational research in APL.
Because of its prevalence in Latin America and
the rapid progress in understanding its pathogenesis and optimizing its therapy,
APL was chosen as the model disease. Member countries currently include Brazil, Chile,
Mexico, and Uruguay.
Prior to joining the IC-APL in 2006, Uruguayan
institutions had the human and technical resources to run clinical trials, but
there was a lack of collaboration between the country’s researchers. The IC-APL
gave hematologists in Uruguay
an opportunity to cooperatively organize the logistics for diagnosis,
monitoring, and treatment through the central lab in Montevideo, which led to a significant improvement
in clinical management.
According to Dr. Sebastian Galeano, secretary of the
Sóciedad Hematologica del Uruguay (SHU), the IC-APL was the first opportunity
for its hematologists to participate in a multicenter clinical research
project. In order to determine their incidence of APL, members of SHU initiated
the Uruguayan Registry in Hematologic Malignancies, primarily developed by the
IC-APL and SHU data manager, Dr. Isabel Moro. They now know not only the
incidence of acute leukemias, but also the rates of CML and lymphomas. SHU is
currently developing an accurate registry for CLL, MDS, and multiple myeloma.
“Our participation in IC-APL has also helped foster better
communication among the members of our Society,” Dr. Galeano commented. “This
experience undoubtedly is an example of how we should manage other hematologic
diseases in order to improve our clinical practice.” Each patient’s diagnosis
is followed within the guidelines outlined in the IC-APL protocol. That
information is shared between the SHU members. Through the IC-APL, Uruguayan
hematologists work with experts in the field from all over the world,
developing their own expertise in APL.
Moreover, they have gained new diagnostic tools, such as
an anti-PML antibody, and improved on those that they already had, particularly
in the field of coagulation. Through improvements in diagnostic procedures,
communication among health workers, and knowledge of the disease, patients with
APL will receive better care.
The IC-APL became successful because of the enormous
effort and enthusiasm of national coordinators, local data managers, and
To learn more about the IC-APL and all of ASH’s global
programs, visit the ASH booth, #129.
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