Treatment outcomes in relapsed acute promyelocytic leukemia patients initially treated with all-trans retinoic acid and arsenic compound-based combined therapies

Treatment outcomes in relapsed acute promyelocytic leukemia patients initially treated with all-trans retinoic acid and arsenic compound-based combined therapies

Contemporary combined therapies that include the use of all-trans retinoic acid (ATRA) and arsenic compounds have reduced relapse rates from ~50 to <10% in acute promyelocytic leukemia (APL) patients, however relapse treatment remains controversial. Treatment outcomes in relapsed patients with AP...

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Main Authors: LU, JIN, HUANG, XIAOJUN, BAO, LI, JIANG, HAO, ZHU, HONGHU, JIANG, BIN
Format: Online
Language:English
Published: D.A. Spandidos 2014
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3861585/
id pubmed-3861585
recordtype oai_dc
spelling pubmed-38615852013-12-13 Treatment outcomes in relapsed acute promyelocytic leukemia patients initially treated with all-trans retinoic acid and arsenic compound-based combined therapies LU, JIN HUANG, XIAOJUN BAO, LI JIANG, HAO ZHU, HONGHU JIANG, BIN Articles Contemporary combined therapies that include the use of all-trans retinoic acid (ATRA) and arsenic compounds have reduced relapse rates from ~50 to <10% in acute promyelocytic leukemia (APL) patients, however relapse treatment remains controversial. Treatment outcomes in relapsed patients with APL previously treated with combined ATRA + arsenic compound therapy were investigated. A retrospective, observational study was conducted of 25 patients with APL (male to female ratio, 17:8; mean age, 36.4±10.3 years) exhibiting first-time relapse following combined ATRA + arsenic compound therapy. These patients were subsequently treated with secondary ATRA + arsenic compound therapy, salvage chemotherapy, monoclonal antibody therapy or intrathecal chemotherapy, between January 1994 and December 2010. The overall remission rate, duration of remission and toxic effects were assessed. Patient outcomes included mortality during secondary induction therapy (6/25, 24.0%); complete recovery from central nervous system (CNS) relapse following intrathecal chemotherapy (1/25, 4.0%); complete remission following ATRA + arsenic compound therapy (10/25, 40.0%), chemotherapy (3/25, 12.0%) and targeted therapy (1/25, 4.0%); and non-remission (NR) following ATRA + arsenic compound therapy (4/25, 16%). Four (16.0%) patients were subsequently treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT), two of which remained disease-free at the end of the study period and two of which succumbed to the disease. Secondary bone marrow and CNS relapse occurred in 14 (56.0%) patients and one (4.0%) patient, respectively. ATRA + arsenic compound-based combination therapy was effective in re-inducing morphological remission in relapsed patients with APL with previous exposure to ATRA + arsenic compounds, producing low molecular remission rates and high risk of secondary relapse. Furthermore, investigation of early allo-HSCT is required to determine its potential as a therapeutic option for re-inducing morphological remission in relapsed patients with APL with previous exposure to ATRA + arsenic compounds. D.A. Spandidos 2014-01 2013-10-25 /pmc/articles/PMC3861585/ /pubmed/24348844 http://dx.doi.org/10.3892/ol.2013.1643 Text en Copyright © 2014, Spandidos Publications http://creativecommons.org/licenses/by/3.0 This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author LU, JIN
HUANG, XIAOJUN
BAO, LI
JIANG, HAO
ZHU, HONGHU
JIANG, BIN
spellingShingle LU, JIN
HUANG, XIAOJUN
BAO, LI
JIANG, HAO
ZHU, HONGHU
JIANG, BIN
Treatment outcomes in relapsed acute promyelocytic leukemia patients initially treated with all-trans retinoic acid and arsenic compound-based combined therapies
author_facet LU, JIN
HUANG, XIAOJUN
BAO, LI
JIANG, HAO
ZHU, HONGHU
JIANG, BIN
author_sort LU, JIN
title Treatment outcomes in relapsed acute promyelocytic leukemia patients initially treated with all-trans retinoic acid and arsenic compound-based combined therapies
title_short Treatment outcomes in relapsed acute promyelocytic leukemia patients initially treated with all-trans retinoic acid and arsenic compound-based combined therapies
title_full Treatment outcomes in relapsed acute promyelocytic leukemia patients initially treated with all-trans retinoic acid and arsenic compound-based combined therapies
title_fullStr Treatment outcomes in relapsed acute promyelocytic leukemia patients initially treated with all-trans retinoic acid and arsenic compound-based combined therapies
title_full_unstemmed Treatment outcomes in relapsed acute promyelocytic leukemia patients initially treated with all-trans retinoic acid and arsenic compound-based combined therapies
title_sort treatment outcomes in relapsed acute promyelocytic leukemia patients initially treated with all-trans retinoic acid and arsenic compound-based combined therapies
description Contemporary combined therapies that include the use of all-trans retinoic acid (ATRA) and arsenic compounds have reduced relapse rates from ~50 to <10% in acute promyelocytic leukemia (APL) patients, however relapse treatment remains controversial. Treatment outcomes in relapsed patients with APL previously treated with combined ATRA + arsenic compound therapy were investigated. A retrospective, observational study was conducted of 25 patients with APL (male to female ratio, 17:8; mean age, 36.4±10.3 years) exhibiting first-time relapse following combined ATRA + arsenic compound therapy. These patients were subsequently treated with secondary ATRA + arsenic compound therapy, salvage chemotherapy, monoclonal antibody therapy or intrathecal chemotherapy, between January 1994 and December 2010. The overall remission rate, duration of remission and toxic effects were assessed. Patient outcomes included mortality during secondary induction therapy (6/25, 24.0%); complete recovery from central nervous system (CNS) relapse following intrathecal chemotherapy (1/25, 4.0%); complete remission following ATRA + arsenic compound therapy (10/25, 40.0%), chemotherapy (3/25, 12.0%) and targeted therapy (1/25, 4.0%); and non-remission (NR) following ATRA + arsenic compound therapy (4/25, 16%). Four (16.0%) patients were subsequently treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT), two of which remained disease-free at the end of the study period and two of which succumbed to the disease. Secondary bone marrow and CNS relapse occurred in 14 (56.0%) patients and one (4.0%) patient, respectively. ATRA + arsenic compound-based combination therapy was effective in re-inducing morphological remission in relapsed patients with APL with previous exposure to ATRA + arsenic compounds, producing low molecular remission rates and high risk of secondary relapse. Furthermore, investigation of early allo-HSCT is required to determine its potential as a therapeutic option for re-inducing morphological remission in relapsed patients with APL with previous exposure to ATRA + arsenic compounds.
publisher D.A. Spandidos
publishDate 2014
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3861585/
_version_ 1612038084167204864

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