Annals of Oncology Advance Access published online on October 14, 2005
Annals of Oncology, doi:10.1093/annonc/mdj019
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1 Haematology, Oncology and BMT Research Centre, Tehran University of Medical Sciences, Tehran, Iran
* To whom correspondence should be addressed. 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.
Received July 10, 2005
Revised August 5, 2005
Accepted August 8, 2005
original article
Treatment of acute promyelocytic leukemia with arsenic trioxide without ATRA and/or chemotherapy
2 Pharmacology Department of Tehran University of Medical Sciences, Tehran, Iran
3 Department of Haematology of Tarbiat Modaress University, Tehran, Iran
K. Alimoghaddam, E-mail: alimgh{at}ams.ac.ir
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