Korean J Med.  2008 Jun;74(6):596-604.

Salvage treatments with all-trans retinoic acid and arsenic trioxide-based regimens in acute promyelocytic leukemia

• Cho YY
• Kim JG
• Chae YS
• Moon JH
• Ahn BM
• Sohn SK

Abstract

BACKGROUND/AIMS: Acute promyelocytic leukemia is a distinct subtype of acute myeloid leukemia with a specific clinical and molecular presentation. Treatment of acute promyelocytic leukemia with all-trans retinoic acid or arsenic trioxide in association with anthracyclin has improved outcomes in this disease. We report the results of all-trans retinoic acid and arsenic trioxide-based treatment regimens in acute promyelocytic leukemia patients diagnosed in a single center.
METHODS
Thirty-seven treatment events in 26 patients with acute promyelocytic leukemia were retrospectively reviewed.
RESULTS
Complete remission was achieved in 29 (78.4%) of 37 treatment events. One-year overall survival rate and 1-year event-free survival rate were 74.3% and 66.3%, respectively. Among 16 patients treated with an arsenic trioxide-based regimen, 14 patients (87.5%) achieved complete remission. The 1-year overall survival rate and 1-year event-free survival rate were 78.4% and 69.6%, respectively.
CONCLUSIONS
The short-term use of arsenic trioxide for salvage treatment of acute promyelocytic leukemia seems to be efficacious and could be a bridge to intensive chemotherapy or stem cell transplantation in terms of minimizing the risk of severe disseminated intravascular coagulation.

Keyword

Acute promyelocytic leukemia; All-trans retinoic acid; Arsenic trioxide

MeSH Terms

Arsenic
Arsenicals
Disease-Free Survival
Humans
Leukemia, Myeloid, Acute
Leukemia, Promyelocytic, Acute
Oxides
Retrospective Studies
Stem Cell Transplantation
Survival Rate
Tretinoin
Arsenic
Arsenicals
Oxides
Tretinoin