Retrospective analysis of 65 Chinese children with acute promyelocytic leukemia: a single center experience.
BACKGROUND
There are very limited data reported about childhood acute promyelocytic leukemia (APL), especially with arsenic trioxide (As2O3) treatment. We review the clinical course and treatment outcome of 65 children APL.


METHODS
Between January 1999 and December 2005, 65 children (<18 years) with newly diagnosed APL were treated.


RESULTS
Three groups of patients were identified according to the different induction regimens. Forty patients were given ATRA alone (group 1, G1), 8 patients were given As2O3 alone (group 2, G2), 15 patients (group 3, G3) were treated with combination of ATRA and As2O3. Two patients received cytosine arabinoside and died at days 2 and 4, respectively. The CR rate of G1 was 95% (38/40). The overall CR rate of G2+G3 was 91.3% (21/23). Toxicity of ATRA and As2O3 were minimal and recoverable during induction. Five children had a hematologic relapse and two developed molecular relapse. Five of them were successfully treated with ATRA alone or combined with As2O3. The 5-year estimate of EFS, DFS and OS between G1 and G2+G3 has no difference.


CONCLUSIONS
As2O3 is an effective and well tolerable therapy for children with APL and it may be used in those who have dose limiting side effects of ATRA, but also for those with newly diagnosed or relapsed APL.
Zhang
Li
L
Department of Pediatrics, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, PR China.
Zhao
Hui
H
Zhu
Xiaofan
X
Chen
Yumei
Y
Zou
Yao
Y
Chen
Xiaojuan
X
D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D008297:Male; D010087:Oxides / Q000627:therapeutic use*; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014212:Tretinoin / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D001152:Arsenicals; D010087:Oxides; D014212:Tretinoin; D000077237:Arsenic Trioxide