Outcome of Therapy-related Acute Promyelocytic Leukemia with or Without Arsenic Trioxide As a Component of Frontline Therapy

Overview

Journal Cancer

Publisher Wiley

Specialty Oncology

Date 2010 Aug 31

PMID 20803607

Citations 13

Authors

Farshid Dayyani

Hagop Kantarjian

Susan OBrien

Sherry Pierce

Dan Jones

Stefan Faderl

Guillermo Garcia-Manero

Jorge Cortes

Farhad Ravandi

Affiliations

Soon will be listed here.

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

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