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Annals of Oncology Advance Access originally published online on October 14, 2005
Annals of Oncology 2006 17(1):131-134; doi:10.1093/annonc/mdj019
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© 2005 European Society for Medical Oncology

Treatment of acute promyelocytic leukemia with arsenic trioxide without ATRA and/or chemotherapy

A. Ghavamzadeh1, K. Alimoghaddam1,*, S. H. Ghaffari1, S. Rostami1, M. Jahani1, R. Hosseini2, A. Mossavi1, E. Baybordi1, A. Khodabadeh1, M. Iravani1, B. Bahar1, Y. Mortazavi3, M. Totonchi1 and N. Aghdami1

1 Haematology, Oncology and BMT Research Centre, Tehran University of Medical Sciences, Tehran; 2 Pharmacology Department of Tehran University of Medical Sciences, Tehran; 3 Department of Haematology of Tarbiat Modaress University, Tehran, Iran

* Correspondence to: Dr K. Alimoghaddam, Haematology, Oncology and BMT Research Centre of Tehran University of Medical Sciences, Shariati Hospital, Kargar Ave., Tehran 14114, Iran. Tel: +98-91-21711635; Fax: +98-21-88004140; E-mail: alimgh{at}ams.ac.ir

Introduction: Arsenic trioxide is effective and approved for treatment of relapsed or refractory acute promyelocytic leukemia (APL) cases resistant to all-trans retinoic acid (ATRA), but its effect on new cases of APL is not clear.

Materials and methods: We studied 111 patients with APL. Arsenic trioxide was infused at 0.15 mg/kg daily dose, until complete remission was achieved. Then, after 28 days of rest, arsenic trioxide was infused daily for 28 days as consolidation therapy. We studied minimal residual disease (MRD) by semi-sensitive reverse transcription polymerase chain reaction (RT–PCR) on peripheral blood samples.

Results: Complete remission was observed in 95 patients (85.6%). With the median (range) follow-up period of 16.5 (1–57) months, 1- and 2-year disease-free survival was 88.3% and 63.7%, respectively; 24 patients relapsed, 19 of whom achieved a second complete remission, again by arsenic trioxide. Third and fourth remissions were seen in some relapsed patients, again by arsenic trioxide. For patients in complete remission, 1- and 3-year survival was 95.5% and 87.6%, respectively. MRD was positive in four (8.3%) out of 48 cases during 1 year after remission induction; three of them relapsed clinically.

Conclusions: Arsenic trioxide is effective as first-line treatment for APL. Results of arsenic trioxide combination therapy with chemotherapy/ATRA requires further study.

Key words: APL, arsenic trioxide, minimal residual disease


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