RARα polymerase chain reaction (PCR) monitoring and safety in elderly patients with de novo acute promyelocytic leukemia (APL) who were treated with either arsenic trioxide (As2O3) or medium-dose cytosine arabinoside (MiDAC) as frontline consolidation regimens. A total of 167 patients (age ?5?years old) received all-trans retinoic acid?+?daunorubicin as induction therapy. Of these patients, 22 died before attaining complete remission; the remaining 145 subjects received MiDAC- or As2O3-based consolidation therapy. As2O3 was superior to MiDAC for improving DFS and OS. This benefit appeared to result from the longer 5-year DFS (92.0 vs. 69.1?%, P?P?2O3 compared to MiDAC. PCR monitoring demonstrated that As2O3 promoted a lower positive rate than MiDAC (21.7 vs. 4.5?%, P?9/L (85.7?%), leukocyte counts 9/L (81.4?%) and severe infection (84.3?%). In contrast, the As2O3 regimen rarely caused leukocyte counts 9/L (22.7?%, P?9/L (37.3?%, P?P?2O3." />
A prospective, observational study of added medium-dose cytosine arabinoside versus As2O3 for elderly patients with acute promyelocytic leukemia
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  • 作者：Bin-Tao Huang ; Qing-Chun Zeng ; Wei-Hong Zhao ; Bing-Sheng Li…
  • 关键词：Elderly patients ; Acute promyelocytic leukemia ; As2O3 ; MiDAC
  • 刊名：Medical Oncology
  • 出版年：2014
  • 出版时间：October 2014
  • 年：2014
  • 卷：31
  • 期：10
  • 全文大小：385 KB
  • 参考文献：1. Powell BL, Moser B, Stock W, et al. Arsenic trioxide improves event-free and overall survival for adults with acute promyelocytic leukemia: North American Leukemia Intergroup Study C9710. Blood. 2010;116:3751-. CrossRef
    2. Huang BT, Zeng QC, Gurung A, et al. The early addition of arsenic trioxide versus high-dose arabinoside is more effective and safe as consolidation chemotherapy for risk-tailored patients with acute promyelocytic leukemia: multicenter experience. Med Oncol. 2012;29:2088-4. CrossRef
    3. Gardin C, Turlure P, Fagot T, et al. Postremission treatment of elderly patients with acute myeloid leukemia in first complete remission after intensive induction chemotherapy: results of the multicenter randomized Acute Leukemia French Association (ALFA) 9803 trial. Blood. 2007;109:5129-5. CrossRef
    4. Prebet T, Gore SD. Treatment of acute promyelocytic leukemia for older patients. J Natl Compr Canc Netw. 2011;9:337-2.
    5. Huang BT, Zhao WH, Zeng QC, et al. Standard intensive chemotherapy is less effective and far more toxic than attenuated induction and post-induction regimen in elderly patients with acute myeloid leukemia. Med Oncol. 2014;31:962. CrossRef
    6. Huang BT, Zeng QC, Zhao WH, et al. How to determine post-FCR therapy for cytogenetic risk-tailored elderly patients with chronic lymphocytic leukemia, maintenance rituximab or observation. Med Oncol. 2014;31:104. CrossRef
    7. Sanz MA, Martín G, González M, et al. Risk-adapted treatment of acute promyelocytic leukemia with alltrans-retinoic acid and anthracycline monochemotherapy: a multicenter study by the PETHEMA group. Blood. 2004;103:1237-3. CrossRef
    8. Cheson BD, Bennett JM, Kopecky KJ, et al. Revised recommendations of the international working group for diagnosis, standardization of response criteria, treatment outcomes, and reporting standards for therapeutic trials in acute myeloid leukemia. J Clin Oncol. 2003;21:4642-. CrossRef
    9. Lo-Coco F, Avvisati G, Vignetti M, et al. Retinoic acid and arsenic trioxide for acute promyelocytic leukemia. N Engl J Med. 2013;369:111-1. CrossRef
    10. Ramirez LY, Huestis SE, Yap TY, et al. Potential chemotherapy side effects: what do oncologists tell parents? Pediatr Blood Cancer. 2009;52:497-02. CrossRef
    11. Miura Y, Suyama K, Takano T. Treatment of acute promyelocytic leukemia. N Engl J Med. 2013;369:1471-. CrossRef
    12. Barbey JT, Pezzullo JC, Soignet SL. Effect of arsenic trioxide on QT interval in patients with advanced malignancies. J Clin Oncol. 2003;21:3609-5. CrossRef
    13. Park JH, Qiao B, Panageas KS, et al. Early death rate in acute promyelocytic leukemia remains high despite all-trans retinoic acid. Blood. 2011;118:1248-4. CrossRef
    14. Adès L, Guerci A, Raffoux E, et al. Very long-term outcome of acute promyelocytic leukemia after treatment with all-trans retinoic acid and chemotherapy: the European APL Group experience. Blood. 2010;115:1690-. CrossRef
  • 作者单位：Bin-Tao Huang (1)
    Qing-Chun Zeng (2)
    Wei-Hong Zhao (3)
    Bing-Sheng Li (4)
    Rui-lin Chen (5)

    1. Department of Hematology, The Affiliated Hospital of Inner Mongolia Medical University, 1 TongDao Avenue North, Hohhot, 010059, People’s Republic of China
    2. Department of Medicine, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, Guangdong, People’s Republic of China
    3. Department of Gastroenterology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010059, People’s Republic of China
    4. Huizhou Medicine Institute, Huizhou, 516003, People’s Republic of China
    5. Department of Medicine, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, People’s Republic of China
  • ISSN：1559-131X
文摘
This open-label, prospective, observational study aimed to evaluate disease-free survival (DFS), overall survival (OS), PML-a href='/search?dc.title=RAR%CE%B1&facet-content-type=ReferenceWorkEntry&sortOrder=relevance' class='reference-link webtrekk-track' gaCategory="Internal link" gaLabel="RARα" gaAction="reference keyword">RARα polymerase chain reaction (PCR) monitoring and safety in elderly patients with de novo acute promyelocytic leukemia (APL) who were treated with either arsenic trioxide (As2O3) or medium-dose cytosine arabinoside (MiDAC) as frontline consolidation regimens. A total of 167 patients (age ?5?years old) received all-trans retinoic acid?+?daunorubicin as induction therapy. Of these patients, 22 died before attaining complete remission; the remaining 145 subjects received MiDAC- or As2O3-based consolidation therapy. As2O3 was superior to MiDAC for improving DFS and OS. This benefit appeared to result from the longer 5-year DFS (92.0 vs. 69.1?%, P?P?2O3 compared to MiDAC. PCR monitoring demonstrated that As2O3 promoted a lower positive rate than MiDAC (21.7 vs. 4.5?%, P?9/L (85.7?%), leukocyte counts 9/L (81.4?%) and severe infection (84.3?%). In contrast, the As2O3 regimen rarely caused leukocyte counts 9/L (22.7?%, P?9/L (37.3?%, P?P?2O3.

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