Improved Outcomes of All-trans-retinoic Acid and Arsenic Trioxide Plus Idarubicin as a Frontline Treatment in Adult Patients With Acute Promyelocytic Leukemia

作者：Shiwei Yang, Rongjun Ma, Xiaoli Yuan, Li Jiang, Jie Shi, Jing Yang, Pingchong Lei, Yuzhu Zang, Xiangli Chen, Yin Zhang, Zhong-Wen Liu, Jianmin Guo, Lin Zhang, Xiaojian Zhu, Zunmin Zhu · 发表于：Clinical Lymphoma Myeloma & Leukemia · 年份：2019 · DOI：10.1016/j.clml.2019.10.003 · 被引用次数：9 · 研究领域：Retinoids in leukemia and cellular processes、Acute Myeloid Leukemia Research、Drug-Induced Ocular Toxicity

Introduction The purpose of this study was to explore the outcomes of all-trans-retinoic acid (ATRA) and arsenic trioxide (ATO) plus idarubicin (IDA) as a frontline treatment in adult patients with acute promyelocytic leukemia (APL). Patients and Methods We analyzed the outcomes of ATRA and intravenous ATO plus IDA as a frontline induction therapy in 118 patients with APL with high-risk (HR) and standard-risk (SR) disease from January 2008 to December 2017. The medical records of 118 patients with APL (HR, n = 45; SR, n = 73) who received the frontline triple combination regimen at Henan Provincial People's Hospital and Tongji Hospital were retrospectively reviewed. Consolidation therapy comprised 6 cycles of ATO and ATRA plus IDA, and IDA was administered in 1 to 4 cycles of consolidation therapy based on the comparable clinical efficacy compared with 6 cycles and fewer side effects to myocardium without subsequent maintenance therapy. Results Of 118 patients, there were 3 (2.5%) early deaths and 115 (97.5%) hematologic complete remissions; 102 (88.7%) of 115 patients achieved molecular complete remission following induction therapy, and all patients were polymerase chain reaction-negative for promyelocytic leukemia-retinoic acid receptor alpha after the first cycle of consolidation therapy. The 5-year overall survival (OS) and event-free survival (EFS) were 93.0% ± 2.9% and 92.4% ± 3.0%, respectively. Early death, hematologic complete remissions, molecular complete remissio...