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Long‐term efficacy of low‐dose all‐trans retinoic acid plus minimal chemotherapy induction followed by the addition of intravenous arsenic trioxide post‐remission therapy in newly diagnosed acute promyelocytic leukaemia
Author(s) -
Lou Yinjun,
Qian Wenbin,
Meng Haitao,
Mai Wenyuan,
Tong Hongyan,
Tong Yin,
Huang Jian,
Jin Jie
Publication year - 2014
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.2076
Subject(s) - arsenic trioxide , medicine , acute promyelocytic leukemia , chemotherapy , gastroenterology , induction chemotherapy , complete remission , retinoic acid , minimal residual disease , surgery , leukemia , arsenic , biochemistry , materials science , chemistry , metallurgy , gene
We evaluated the efficacy of low‐dose all‐trans retinoic acid (ATRA) plus minimal chemotherapy for induction in newly diagnosed acute promyelocytic leukaemia (APL). Furthermore, we compared its long‐term outcome with or without the addition of intravenous arsenic trioxide (ATO) in post‐remission therapy. From January 2004 to September 2011, a total of 109 patients with a median age of 41 years (range 14–73) were enrolled in the study. Two arms were assigned according to post‐remission protocols: ATO group cases were subsequently treated with intravenous ATO, standard chemotherapy, and ATRA. No‐ATO group cases were subsequently treated with chemotherapy and ATRA only. Patients were monitored of minimal residual disease (MRD) by reverse‐transcriptase polymerase chain reaction. The haematologic complete remission (CR) rate was 96.3%. The early death rate was 0.9%. At a median follow‐up of 49 months (range 8–102 months), the Kaplan–Meier estimates of 5‐year relapse‐free survival were significantly better for patients in the ATO group than in the no‐ATO group, 94.4% vs 54.8% ( p = 0.0001), and the 5‐year overall survival rate was 95.7% vs 64.1%, in the two groups ( p = 0.003). Our data show that low‐dose ATRA plus minimal chemotherapy exhibits efficacy in induction therapy for untreated APL and suggest that the addition of ATO to post‐remission therapy significantly improves the long‐term outcome. Copyright © 2013 John Wiley & Sons, Ltd.