All-trans Retinoic Acid, Arsenic Trioxide, and Anthracycline-based Chemotherapy Improves Outcome in Newly Diagnosed Acute Promyelocytic Leukemia Regardless of FLT3-ITD Mutation Status

Xu, Linwei; Su, Yuxi; Tao, Hong‐Fang

doi:10.1007/s11596-021-2377-3

Cited by 4 publications

(1 citation statement)

References 32 publications

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“…The responses of the patients to the different treatment regimens were compared, in which ATRA combined with arsenic and anthracycline had the lowest early mortality. The best regimen for APL patients with bcr-3 is still ATRA combined with arsenic and anthracycline agents ( 24 – 26 ). However, we compared the effects of using the ATRA combined with arsenic and anthracycline regimen in different risk groups with those of not using this regimen, finding that the high-risk group achieved better results with this regimen, so we recommend that high-risk bcr3 patients use this regimen for the relevant treatments.…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of 82 cases of acute promyelocytic leukemia with PML-RARα short isoform in children and adults

Huang,

Zhang,

Zheng

2024

Front. Oncol.

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BackgroundAcute promyelocytic leukemia (APL) with PML/RARα fusion gene is a distinct variant of acute myeloid leukemia. According to the different break sites of the PML gene, there are three transcripts: Long (bcr1), Variant (bcr2) and Short (bcr3).MethodsWe retrospectively analyzed 82 APL cases with PML-RARα short isoform.ResultsA total of 384 patients with APL were seen, of which 85(22.14%) had PML/RARα short isoform (bcr3) and 82 met the inclusion criteria. The median age was 33.5 years (range, 2-72 years). The incidences of hemorrhage in the intermediate- and high-risk group were higher, but only the incidence between medium and low risk differed statistically (P=0.006), and the incidences of fever, fatigue, splenomegaly, and lymph node enlargement and differentiation syndrome (DS) in those groups were not statistically significant (P>0.05). FLT3 gene mutation rate and the mortality rate of the high-risk group were significantly higher than that of other groups (P=0.040 and P=0.004, P=0.041 and P=0.037, respectively). The mortality rate was lowest (4.26%) in the group treated with ATRA combined with arsenic and anthracycline. The 3-year OS and the 3-year DFS of the low and intermediate-risk group were better (P=0.019 and P=0.017, respectively).ConclusionsATRA combined with arsenic and anthracycline had significant impact on outcomes in APL with PML-RARα short isoform.

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Section: Discussionmentioning

confidence: 99%

Clinical analysis of 82 cases of acute promyelocytic leukemia with PML-RARα short isoform in children and adults

Huang,

Zhang,

Zheng

2024

Front. Oncol.

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An overview of arsenic trioxide-involved combined treatment algorithms for leukemia: basic concepts and clinical implications

Jiang¹,

Shen²,

Zhi³

et al. 2023

Cell Death Discov.

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Arsenic trioxide is a first-line treatment drug for acute promyelocytic leukemia, which is also effective for other kinds of leukemia. Its side effects, however, limit its clinical application, especially for patients with complex leukemia symptoms. Combination therapy can effectively alleviate these problems. This review summarizes the research progress on the combination of arsenic trioxide with anticancer drugs, vitamin and vitamin analogs, plant products, and other kinds of drugs in the treatment of leukemia. Additionally, the new progress in arsenic trioxide-induced cardiotoxicity was summarized. This review aims to provide new insights for the rational clinical application of arsenic trioxide.

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Highly Curative Treatment of High-Risk Acute Promyelocytic Leukemia: Induction and Consolidation with ATRA+ATO+anthracyclines and Maintenance with ATRA+RIF

Liu,

Tong,

Chen

et al. 2024

BLCTT

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Background The aim of the study was to evaluate the efficacy and safety of induction and consolidation with all-trans retinoic acid (ATRA) +arsenic trioxide (ATO) +anthracyclines and maintenance with ATRA +Realgar- Indigo naturalis formula (RIF) for high-risk APL. Methods Twenty-one patients with high-risk APL treated with ATRA+ATO+ anthracyclines for induction and consolidation and ATRA+RIF for maintenance from 2012 to 2021 were analyzed. Endpoints include morphological complete remission (CR) and complete molecular remission (CMR), early death (ED) and relapse, survival and adverse events (AEs). Results After induction treatment, all 21 patients (100%) achieved morphological CR and 14 people (66.7%) achieved CMR. Five of the 21 patients did not undergo immunological minimal residual disease (MRD) examination after induction; however, 14 of the remaining 16 patients were MRD negative (87.5%). The median time to achieve CR and CMR was 26 days (range: 16–44) and 40 days (range: 22–75), respectively. The cumulative probability of achieving CR and CMR in 45 days was 100% and 76.2% (95% CI: 56.9–91.3%), respectively. All patients achieved CMR and MRD negativity after the three courses of consolidation treatment. The median follow-up was 66 months (25–142), with no central nervous system relapse and bone marrow morphological or molecular relapse until now, and all patients survived with 100% overall survival and 100% event-free survival. Grade 4 adverse events (AEs) were observed in 3 patients (14.3%) during the induction period including arrhythmia (n = 1), pulmonary infection (n = 1) and respiratory failure (n = 1); and the most frequent grade 3 AEs were pulmonary infection, accounting for 62.0% and 28.6%, respectively, during induction and consolidation treatment, followed by neutropenia, accounting for 42.9% and 38.1%, respectively. Conclusion For newly diagnosed high-risk APL patients, induction and consolidation with ATRA+ATO+anthracyclines and maintenance with ATRA+RIF is a highly curative treatment approach.

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All-trans Retinoic Acid, Arsenic Trioxide, and Anthracycline-based Chemotherapy Improves Outcome in Newly Diagnosed Acute Promyelocytic Leukemia Regardless of FLT3-ITD Mutation Status

Cited by 4 publications

References 32 publications

Clinical analysis of 82 cases of acute promyelocytic leukemia with PML-RARα short isoform in children and adults

Clinical analysis of 82 cases of acute promyelocytic leukemia with PML-RARα short isoform in children and adults

An overview of arsenic trioxide-involved combined treatment algorithms for leukemia: basic concepts and clinical implications

Highly Curative Treatment of High-Risk Acute Promyelocytic Leukemia: Induction and Consolidation with ATRA+ATO+anthracyclines and Maintenance with ATRA+RIF

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