Retinoic Acid And Middle School Harringtonine Treatment Of Acute Promyelocytic Leukemia Clinical Research

Objective To evaluate the feasibility, efficacy and side-effect of regimen combine all-trans retinoic acid with homoharringtonine in new diagnosis acute promyelocytic leukemia in a randomized comparison.Methods 26 patients with new diagnosis acute promyelocytic leukemia were randomized in two groups, one group received an induction therapy with ATRA plus homoharringtonine until CR, followed by two courses of consolidation therapy with HA regimen. Another group received an induction and consolidation therapy in accordance with NCCN clinical practice guidelines in oncology(inducted with ATRA plus anthracycline and consolidated with anthracycline-based regimen ). Statistical analysis the expression of fusion gene, the rate of complete remission, side-effect and disease-free survival after induction and consolidation therapy, respectively. Results In HHT group all patients achieved hematological complete remission after induction therapy, the rate of CR is 100%, there is a same result in control group except one early death, the rate of CR is 92%. In HHT group the rate of fusion gene negative after induction therapy is 63.6% and 100% after 1 course consolidation therapy, in contrast to control group is 38.5% and 91.7%, respectively. The cumulative overall survival in HHT group and control group is 85.7% and 75.6%, respectively. There is no significance in toxicity.Conclusion The result in randomized comparison suggests regimen ATRA plus homoharringtonine followed by consolidation therapy with HA has no significance with ATRA plus anthracycline followed by anthracycline-based consolidation therapy in new diagnosis acute promyelocytic leukemia. This regimen can be a new choice in treatment of acute promyelocytic leukemia and can also achieve a molecular remission.