In a nutshell
This study aimed to investigate if arsenic trioxide was safe and effective as a maintenance treatment for patients with acute promyelocytic leukemia. This study concluded that this maintenance treatment was safe and effective in these patients.
Some background
Acute promyelocytic leukemia (APL) is an aggressive type of acute myeloid leukemia (AML). A frontline treatment for APL involves all-trans retinoic acid (ATRA). Arsenic trioxide (Trisenox) is also used to treat APL in patients that relapsed. However, the role of arsenic trioxide combined with ATRA and vitamin C (ascorbic acid) in maintaining first complete remission (CR1) in APL is unclear.
Methods & findings
This study involved 129 adult patients with APL who achieved CR1 with standard induction (first treatment) and consolidation (therapy given after first treatment to kill any remaining cancer cells) treatment. Induction treatments included ATRA and daunorubicin (Cerubidine). Consolidation treatments included daunorubicin and cytarabine (Cytosar-U). All patients underwent maintenance treatment of ATRA, arsenic trioxide, and ascorbic acid (AAA) for 2 weeks every 2 months. Maintenance treatment lasted for 2 years.
After an average follow up time of 100 months, 13% of patients developed first relapse (R1). This occurred after an average of 19 months from CR1. All patients achieved CR2 with oral arsenic trioxide-based salvage therapy.
The 5-year rate of relapse-free survival (RFS) was 89%. The 10-year rate of RFS was 85%. The 5-year rate of overall survival (OS) was 94%. The 10-year rate of OS was 87%.
Most side effects were mild and moderate and included low white blood cell levels, headache, and liver problems.
The bottom line
This study concluded that CR1 maintenance with AAA is safe and results in favorable long-term survival in patients with APL.
Published By :
Cancer
Date :
May 04, 2020
