Arsenic Trioxide Therapy In The Treatment Of Newly Diagnosed Cute Promyelocytic Leukemia

Objective: To analyse the effects of arsenic trioxide-based treatment oncomplete remission and long-term survival of different induction regimens andpost-remission therapy in patients with primary acute promyelocytic leukemia,and observe the side effects.Methods: We retrospectively analyzed the primary acute promyelocyticleukemia cases in our hospital from January2002to May2011, compared thecomplete remission(CR)rate between groups of different induction regimens.We also compared the molecular remission(MR) rate, relapse rate, overallsurvival(OS) and disease free survival(DFS)among groups of differentpost-remission therapy. We used t test and χ2test, Kaplan-Meier survival curveand Log-Rank test by SPSS for statistics analysis.Results:(1)210patients were included, The induction regimen of singleArsenic Trioxide(ATO)had complete remission(CR)rate of100%,comparedwith the regimen of ATO combined with ATRA of96.4%(p>0.05),the time toget remission had no significant difference.(2)After getting CR, post-remissiontherapy is an important prognostic factor of long-term survival. The group ofpost-remission treatment with ATO single-regimen had a cumulative incidenceof relapse rate25.5%,much higher than the group of post-remission treatmentwith combination of ATO and chemotherapy sequentially, which had a relapserate of only6.7%(p=0.011).(3)The1-year,2-year,and3-years overall survivalrate of the two groups are both over95%. The1-year,2-year,and3-years DFSof ATO single-regimen group is90.9%,81.8%,76.4%,while of the sequentialtherapy group is97.1%,96.1%,93.1%,(p=0.031).(4)We detected the propertime for chemotherapy in post-remission therapy. The two groups with different time to add chemotherapy made no significant difference in long-term results,while the group adding chemotherapy immediately after CR had the shortertime to get molecular remissionConclusions: The regimens included ATO had a high CR rate and shortperiod to CR. The single-element ATO therapy made no difference in CR rateand period to CR with ATO/ATRA therapy, and had a low rate of APLdifferentiation syndrome. Compared with the single-element ATO therapy inthe post-remission treatment, the combination with ATO and chemotherapysequentially had a high MRR, a low relapse rate, and would significantlyimprove the disease-free survival of primary APL patients.