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.

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.

• Authors: Mindy Leech, Lawrence Morris, Moishe Stewart, B Douglas Smith, Asad Bashey, Kent Holland, Scott Solomon, Xu Zhang, Hetty E Carraway, Keith Pratz, Steven D Gore, Amer M Zeidan
• Journal: Clinical lymphoma, myeloma & leukemia (Clin Lymphoma Myeloma Leuk) Vol. 15 Issue 5 Pg. 292-7 (May 2015) ISSN: 2152-2669 [Electronic] United States
• PMID: 25499624 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

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

Topics

• 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, mortality)
• Male
• Middle Aged
• Oxides (therapeutic use)
• Proportional Hazards Models
• Retrospective Studies
• Treatment Outcome
• Young Adult