Mindy Leech1, Lawrence Morris1, Moishe Stewart2, B Douglas Smith2, Asad Bashey1, Kent Holland1, Scott Solomon1, Xu Zhang3, Hetty E Carraway4, Keith Pratz2, Steven D Gore5, Amer M Zeidan6. 1. Blood and Marrow Transplant Program, Northside Hospital, Atlanta, GA. 2. Department of Oncology, Johns Hopkins University, Baltimore, MD. 3. Department of Mathematics and Statistics, Georgia State University, Atlanta, GA. 4. Leukemia Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH. 5. Section of Hematology, Department of Internal Medicine, Yale University, New Haven, CT. 6. Section of Hematology, Department of Internal Medicine, Yale University, New Haven, CT. Electronic address: amer.zeidan@yale.edu.
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.
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.
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