Published in:
01-09-2012 | Original Paper
The early addition of arsenic trioxide versus high-dose arabinoside is more effective and safe as consolidation chemotherapy for risk-tailored patients with acute promyelocytic leukemia: multicenter experience
Authors:
Bin-Tao Huang, Qing-Chun Zeng, Arati Gurung, Wei-Hong Zhao, Zhen Xiao, Bing-Sheng Li
Published in:
Medical Oncology
|
Issue 3/2012
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Abstract
The purpose of the study was to evaluate event-free survival (EFS), overall survival (OS) and safety for early addition of arsenic trioxide (As2O3) as frontline consolidation therapy compared to high-dose arabinoside (HiDAC) in adult patients with de novo acute promyelocytic leukemia (APL). 271 patients (aged 17–65 years) received consolidation therapy containing As2O3 (two 21-day courses) or HiDAC regimen. EFS at 5 years was 75% versus 54% (P < 0.001), and OS at 5 years was 83% versus 71% (P = 0.002) in As2O3 and HiDAC treatment arms. 139 patients treated with As2O3, EFS at 5 years reached 79% versus 56% (P = 0.014), but OS at 5 years was 77% versus 84% (P = 0.32) in low-risk (WBC ≤ 10 × 109/L) and high-risk (WBC > 10 × 109/L) cohorts. Further, patients treated with As2O3 rarely incurred agranulocytosis (1.4%, P < 0.001), or severe infection (0.7%, P < 0.001). It is still very well tolerated compared to HiDAC. We confirmed that As2O3 as a first-line consolidation regimen provided significant benefits of OS to patients with APL. The As2O3 regimen made low-risk patients gain more EFS benefits than high-risk group. The high-risk cohort receiving As2O3 overcame the negative impact, yielding OS similar to that for with the low-risk patients treated with As2O3.