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Outcome of therapy-related acute promyelocytic leukemia with or without arsenic trioxide as a component of frontline therapy
Article first published online: 27 AUG 2010
Copyright © 2010 American Cancer Society
Volume 117, Issue 1, pages 110–115, 1 January 2011
How to Cite
Dayyani, F., Kantarjian, H., O'Brien, S., Pierce, S., Jones, D., Faderl, S., Garcia-Manero, G., Cortes, J. and Ravandi, F. (2011), Outcome of therapy-related acute promyelocytic leukemia with or without arsenic trioxide as a component of frontline therapy. Cancer, 117: 110–115. doi: 10.1002/cncr.25585
- Issue published online: 16 DEC 2010
- Article first published online: 27 AUG 2010
- Manuscript Accepted: 20 JUL 2010
- Manuscript Revised: 15 JUN 2010
- Manuscript Received: 17 FEB 2010
- therapy-related acute promyelocytic leukemia;
- arsenic trioxide;
- all-trans-retinoic acid
Patients with therapy-related acute promyelocytic leukemia (t-APL) have been commonly exposed to topoisomerase inhibitors and may potentially benefit from induction regimens omitting anthracyclines.
Retrospective analysis of the outcomes of 29 patients with t-APL who were either treated with arsenic trioxide (ATO) and all-trans-retinoic acid (ATRA) or with standard ATRA plus anthracycline-based chemotherapy was performed.
Prior therapy included chemotherapy alone, radiation alone, or a combination of the 2 in 19%, 33%, and 47% of patients, respectively. The combination of ATO and ATRA (n = 19) for induction resulted in a similar remission rate compared with ATRA plus chemotherapy (n = 10) (89% vs 70%; P = .35). The median overall survival for the patients treated with ATRA plus ATO was not reached compared with that for patients treated with ATRA plus chemotherapy (161 weeks; P = .79).
In this cohort of t-APL patients, outcomes with ATO and ATRA appeared to be comparable to anthracycline-containing induction regimens. This combination may be preferable in t-APL patients to avoid any risk of anthracycline-induced toxicities. Cancer 2011. © 2010 American Cancer Society.