Li Zhang1, Hui Zhao, Xiaofan Zhu, Yumei Chen, Yao Zou, Xiaojuan Chen. 1. Department of Pediatrics, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, PR China.
Abstract
BACKGROUND: There are very limited data reported about childhood acute promyelocytic leukemia (APL), especially with arsenic trioxide (As2O3) treatment. We review the clinical course and treatment outcome of 65 children APL. PROCEDURE: Between January 1999 and December 2005, 65 children (<18 years) with newly diagnosed APL were treated. RESULTS: Three groups of patients were identified according to the different induction regimens. Forty patients were given ATRA alone (group 1, G1), 8 patients were given As2O3 alone (group 2, G2), 15 patients (group 3, G3) were treated with combination of ATRA and As2O3. Two patients received cytosine arabinoside and died at days 2 and 4, respectively. The CR rate of G1 was 95% (38/40). The overall CR rate of G2+G3 was 91.3% (21/23). Toxicity of ATRA and As2O3 were minimal and recoverable during induction. Five children had a hematologic relapse and two developed molecular relapse. Five of them were successfully treated with ATRA alone or combined with As2O3. The 5-year estimate of EFS, DFS and OS between G1 and G2+G3 has no difference. CONCLUSION: As2O3 is an effective and well tolerable therapy for children with APL and it may be used in those who have dose limiting side effects of ATRA, but also for those with newly diagnosed or relapsed APL.
BACKGROUND: There are very limited data reported about childhood acute promyelocytic leukemia (APL), especially with arsenic trioxide (As2O3) treatment. We review the clinical course and treatment outcome of 65 children APL. PROCEDURE: Between January 1999 and December 2005, 65 children (<18 years) with newly diagnosed APL were treated. RESULTS: Three groups of patients were identified according to the different induction regimens. Forty patients were given ATRA alone (group 1, G1), 8 patients were given As2O3 alone (group 2, G2), 15 patients (group 3, G3) were treated with combination of ATRA and As2O3. Two patients received cytosine arabinoside and died at days 2 and 4, respectively. The CR rate of G1 was 95% (38/40). The overall CR rate of G2+G3 was 91.3% (21/23). Toxicity of ATRA and As2O3 were minimal and recoverable during induction. Five children had a hematologic relapse and two developed molecular relapse. Five of them were successfully treated with ATRA alone or combined with As2O3. The 5-year estimate of EFS, DFS and OS between G1 and G2+G3 has no difference. CONCLUSION:As2O3 is an effective and well tolerable therapy for children with APL and it may be used in those who have dose limiting side effects of ATRA, but also for those with newly diagnosed or relapsed APL.
Authors: L Zhang; A Samad; M S Pombo-de-Oliveira; G Scelo; M T Smith; J Feusner; J L Wiemels; C Metayer Journal: Blood Rev Date: 2014-09-30 Impact factor: 8.250