Real-life experience of a brief arsenic trioxide-based consolidation chemotherapy in the management of acute promyelocytic leukemia: favorable outcomes with limited anthracycline exposure and shorter consolidation therapy

Clin Lymphoma Myeloma Leuk. 2015 May;15(5):292-7. doi: 10.1016/j.clml.2014.11.001. Epub 2014 Nov 15.

Abstract

Background: Anthracyclines have activity against acute promyelocytic leukemia (APL) but can cause cardiac toxicity and secondary malignancy. The all-trans retinoic acid (ATRA)-arsenic trioxide (ATO) combination is an effective noncytotoxic approach for APL. However, its efficacy against high-risk APL (white blood cell count > 10,000/μL) has not been documented. Also, it requires ≥ 8 months to complete therapy.

Patients and methods: We report a retrospective analysis of 63 patients with APL given one cycle of ATO-based consolidation chemotherapy.

Results: The 5-year overall survival, event-free survival, and leukemia-free survival was 93% (95% confidence interval [CI], 82%-97%), 89% (95% CI, 77%-95%), and 92% (95% CI, 80%-97%), respectively.

Conclusion: These data have confirmed that an abbreviated ATO-based chemotherapy regimen is an effective consolidation therapy for APL, including high-risk APL, and can be completed within 4 months.

Keywords: APL; ATO; All-trans retinoic acid; Anthracyclines; Promyelocytic leukemia-retinoic acid receptor α.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anthracyclines / therapeutic use
  • Antineoplastic Agents / therapeutic use*
  • Arsenic Trioxide
  • Arsenicals / therapeutic use*
  • Consolidation Chemotherapy
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Leukemia, Promyelocytic, Acute / drug therapy*
  • Leukemia, Promyelocytic, Acute / mortality
  • Male
  • Middle Aged
  • Oxides / therapeutic use*
  • Proportional Hazards Models
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Anthracyclines
  • Antineoplastic Agents
  • Arsenicals
  • Oxides
  • Arsenic Trioxide