A prospective, observational study of added medium-dose cytosine arabinoside versus As2O3 for elderly patients with acute promyelocytic leukemia

Medical Oncology
Bin-Tao HuangRui-lin Chen

Abstract

This open-label, prospective, observational study aimed to evaluate disease-free survival (DFS), overall survival (OS), PML-RARα polymerase chain reaction (PCR) monitoring and safety in elderly patients with de novo acute promyelocytic leukemia (APL) who were treated with either arsenic trioxide (As2O3) or medium-dose cytosine arabinoside (MiDAC) as frontline consolidation regimens. A total of 167 patients (age≥65 years old) received all-trans retinoic acid + daunorubicin as induction therapy. Of these patients, 22 died before attaining complete remission; the remaining 145 subjects received MiDAC- or As2O3-based consolidation therapy. As2O3 was superior to MiDAC for improving DFS and OS. This benefit appeared to result from the longer 5-year DFS (92.0 vs. 69.1%, P<0.01) and OS (94.5 vs. 79.7%, P<0.05) of As2O3 compared to MiDAC. PCR monitoring demonstrated that As2O3 promoted a lower positive rate than MiDAC (21.7 vs. 4.5%, P<0.05), but this treatment had no advantage for maintaining a low positive rate in the high-risk group. The most common life-threatening adverse drug effects in patients with MiDAC were platelet counts<25×10(9)/L (85.7%), leukocyte counts<1.0×10(9)/L (81.4%) and severe infection (84.3%). In contrast, the A...Continue Reading

References

Sep 27, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jean T BarbeySteven L Soignet
Dec 16, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Bruce D ChesonInternational Working Group for Diagnosis, Standardization of Response Criteria, Treatment Outcomes, and Reporting Standards
Dec 23, 2008·Pediatric Blood & Cancer·Lisa Ysela RamirezEric Kodish
Mar 12, 2011·Journal of the National Comprehensive Cancer Network : JNCCN·Thomas Prebet, Steven D Gore
Jul 12, 2013·The New England Journal of Medicine·Francesco Lo-CocoStudy Alliance Leukemia
Oct 11, 2013·The New England Journal of Medicine·Francesco Lo-CocoUwe Platzbecker
Oct 11, 2013·The New England Journal of Medicine·Yuji MiuraToshimi Takano

Citations

Nov 6, 2015·Current Pharmacology Reports·Rodica P Bunaciu, Andrew Yen

Related Concepts

Trisenox
Antineoplastic Chemotherapy Protocols
Arsenicals
Cytonal
Cerubidine
Oxides
Vesanoid
Acute Promyelocytic Leukemia
Survival Rate
Nested Polymerase Chain Reaction

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