ATO/ATRA/anthracycline-chemotherapy sequential consolidation achieves long-term efficacy in primary acute promyelocytic leukemia

PLoS One. 2014 Aug 14;9(8):e104610. doi: 10.1371/journal.pone.0104610. eCollection 2014.

Abstract

The combination of all-trans retinoic acid (ATRA) and arsenic trioxide (As2O3, ATO) has been effective in obtaining high clinical complete remission (CR) rates in acute promyelocytic leukemia (APL), but the long-term efficacy and safety among newly diagnosed APL patients are unclear. In this retrospective study, total 45 newly diagnosed APL patients received ATRA/chemotherapy combination regimen to induce remission. Among them, 43 patients (95.6%) achieved complete remission (CR) after induction therapy, followed by ATO/ATRA/anthracycline-based chemotherapy sequential consolidation treatment with a median follow-up of 55 months. In these patients, the estimated overall survival (OS) and the relapse-free survival (RFS) were 94.4% ± 3.9% and 94.6 ± 3.7%, respectively. The toxicity profile was mild and reversible. No secondary carcinoma was observed. These results demonstrated the high efficacy and minimal toxicity of ATO/ATRA/anthracycline-based chemotherapy sequential consolidation treatment for newly diagnosed APL in long-term follow-up, suggesting a potential frontline therapy for APL.

MeSH terms

  • Adolescent
  • Adult
  • Anthracyclines / administration & dosage
  • Anthracyclines / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Arsenic Trioxide
  • Arsenicals / administration & dosage
  • Arsenicals / adverse effects
  • Child
  • Consolidation Chemotherapy / adverse effects
  • Consolidation Chemotherapy / methods
  • Disease-Free Survival
  • Female
  • Humans
  • Leukemia, Promyelocytic, Acute / drug therapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy
  • Oxides / administration & dosage
  • Oxides / adverse effects
  • Remission Induction / methods
  • Retrospective Studies
  • Treatment Outcome
  • Tretinoin / administration & dosage
  • Tretinoin / adverse effects
  • Young Adult

Substances

  • Anthracyclines
  • Arsenicals
  • Oxides
  • Tretinoin
  • Arsenic Trioxide

Grants and funding

The authors have no support or funding to report.