Prolonged treatment with arsenic trioxide (ATO) and all-trans-retinoic acid (ATRA) for relapsed acute promyelocytic leukemia previously treated with ATRA and chemotherapy

被引:0
作者
Laura Cicconi
Massimo Breccia
Luca Franceschini
Roberto Latagliata
Matteo Molica
Mariadomenica Divona
Daniela Diverio
Manuela Rizzo
Tiziana Ottone
Licia Iaccarino
Valentina Alfonso
Robin Foa
Maria Teresa Voso
Francesco Lo-Coco
机构
[1] University Tor Vergata,Department of Biomedicine and Prevention
[2] Sapienza University,Department of Cellular Biotechnologies and Hematology
[3] Policlinico Tor Vergata,undefined
来源
Annals of Hematology | 2018年 / 97卷
关键词
Acute promyelocytic leukemia; ATO; ATRA; Molecular relapse; Stem cell transplant;
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摘要
Prolonged therapy with all-trans-retinoic acid (ATRA) and arsenic trioxide (ATO) is highly effective in newly diagnosed acute promyelocytic leukemia (APL) but there is limited data on the efficacy of this regimen in the relapse setting. We report here on 22 APL patients treated with prolonged ATRA-ATO therapy at the time of disease relapse. Twenty patients obtained molecular complete remission (CRm) after 2 cycles (90%). Of these, two patients underwent hematopoietic stem cell transplant (HSCT) while the remaining proceeded to receive additional cycles (up to a total of 5) of ATRA-ATO. With a median follow-up of 58 months from the time of relapse (range: 21–128 months), the 4-year OS probability was 0.85 (95% CI 0.61–0.94), DFS was 0.74 (95% CI 0.49–0.88), and EFS 0.68 (95% CI 0.45–0.83). Two patients were resistant to ATRA-ATO salvage and five relapsed at a median of 19 months. Of these, four died due to progressive disease while three relapsed achieved a new CRm after further salvage therapy. This experience confirms the potentially curative effect of prolonged ATRA-ATO therapy in relapsed APL, especially in patients with long first complete remission.
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页码:1797 / 1802
页数:5
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