Short-term intensive consolidation therapy after all-trans retinoic acid in acute promyelocytic leukemia.
Complete remission induced by all-trans retinoic acid (ATRA) in acute promyelocytic leukemia is short lived, and several consolidation chemotherapy courses usually are given to reduce the relapse rate. To assess the value of short-term intensive consolidation, 38 patients with newly diagnosed acute promyelocytic leukemia entered a prospective study in which induction therapy with ATRA immediately was followed by a single course of mitoxantrone plus high-dose cytarabine (3 g/m2 every 12 hours, days 1-4), with no further treatment. Complete remission was achieved in 31 patients (81.6%) after a median time of 49 days of ATRA (to which chemotherapy was added at entry in 10 patients with leukocytosis). Thirty patients received the planned consolidation course. After a median follow-up of 36 months, four of these patients have relapsed and 24 are still in first complete remission, for an estimated disease-free survival of 75% at 60 months. The authors conclude that this single course consolidation of ATRA-induced remission provides excellent long-term control of acute promyelocytic leukemia.
Sousa
A B
AB
Serviço de Hematologia, Hospital dos Capuchos, Lisbon, Portugal.
Fernandes
J P
JP
Ferreira
G
G
Bernardo
M
M
Conduto
A
A
Costa
I
I
Cruz
E
E
Gonçalves
A J
AJ
Monteiro
A
A
Nunes
O
O
Ribeiro
P
P
Rodrigues
A S
AS
Sousa
M
M
Veiga
J
J
Gouveia
J
J
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D011446:Prospective Studies; D012074:Remission Induction; D016019:Survival Analysis; D014212:Tretinoin / Q000008:administration & dosage*
D003561:Cytarabine; D014212:Tretinoin; D008942:Mitoxantrone