title: [Treatment results of intermittent and cyclic regimen with ATRA and chemotherapy in childhood acute promyelocytic leukemia. Children's Cancer and Leukemia Study Group].
abstract: An intermittent and cyclic regimen with All-Trans Retinoic Acid (ATRA) and intensive chemotherapy was conducted due to pharmacokinetic studies on ATRA for acute promyelocytic leukemia (APL) in children. We have treated 17 children with APL using ATRA for remission induction followed by an intermittent schedule of ATRA plus intensive chemotherapy (APL-ATRA protocol). There were 10 males and 7 females. The median age was 9.0 years old. The median baseline white blood cell count was 12.1 x 10(3)/microliter, hemoglobin 7.8 g/dl, platelet 4.5 x 10(4) microliters at diagnosis. Sixteen patients showed t(15; 17) translocation. RT-PCR analysis was available in 15 patients and showed PML/RAR alpha rearrangement in all patients. Overall, 13 or 17 newly diagnosed patients (88%) achieved complete remission and EFS was 67%. Compared to the control (same chemotherapy without ATRA regimen), remission induction and EFS were significantly increased. The toxicity of ATRA consisted of retinoic acid syndrome in 1 and pseudotumor cerebli in another. Other toxicities included headache, chelitis, gastrointestinal trouble and bone pain. These results suggest that intermittent and cyclic regimen with ATRA and intensive chemotherapy (APL-ATRA protocol) is highly effective for APL patients.
authors.affiliation: Department of Pediatrics, Aichi Medical University.
authors.forename: T
authors.initials: T
authors.lastname: Hirota
authors.forename: T
authors.initials: T
authors.lastname: Fujimoto
authors.forename: N
authors.initials: N
authors.lastname: Katano
authors.forename: M
authors.initials: M
authors.lastname: Tsurasawa
authors.forename: H
authors.initials: H
authors.lastname: Eguchi
authors.forename: N
authors.initials: N
authors.lastname: Nakadate
authors.forename: A
authors.initials: A
authors.lastname: Kamitamari
authors.forename: K
authors.initials: K
authors.lastname: Kawakami
authors.forename: K
authors.initials: K
authors.lastname: Nishikawa
authors.forename: K
authors.initials: K
authors.lastname: Asami
authors.forename: A
authors.initials: A
authors.lastname: Shirahata
authors.forename: S
authors.initials: S
authors.lastname: Koizumi
authors.forename: H
authors.initials: H
authors.lastname: Mugishima
authors.forename: T
authors.initials: T
authors.lastname: Gushiken
authors.forename: N
authors.initials: N
authors.lastname: Hyakuna
authors.forename: M
authors.initials: M
authors.lastname: Imaizumi
authors.forename: K
authors.initials: K
authors.lastname: Komatu
authors.forename: K
authors.initials: K
authors.lastname: Takitani
authors.forename: M
authors.initials: M
authors.lastname: Miyake
authors.forename: T
authors.initials: T
authors.lastname: Yanase
mesh_terms: D015250:Aclarubicin / Q000008:administration & dosage; D000284:Administration, Oral; D000293:Adolescent; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002648:Child; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003630:Daunorubicin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D011239:Prednisolone / Q000008:administration & dosage; D014212:Tretinoin / Q000008:administration & dosage* / Q000009:adverse effects; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D000970:Antineoplastic Agents; D003561:Cytarabine; D014212:Tretinoin; D014750:Vincristine; D015250:Aclarubicin; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone; C015019:enocitabine; D015122:Mercaptopurine; D003630:Daunorubicin