Single-agent arsenic trioxide in the treatment of children with newly diagnosed acute promyelocytic leukemia.
The aim of this study was to determine the efficacy and safety of treatment of pediatric acute promyelocytic leukemia (APL) with single-agent arsenic trioxide (ATO). A total of 19 children (< or = 15 years of age) with newly diagnosed APL were treated with single-agent ATO for remission induction and postremission therapy. Seventeen of the children (89.5%) achieved complete hematologic remission, and 2 early deaths occurred from intracranial hemorrhage. ATO-induced leukocytosis was observed in 13 (68.4%) patients. Other ATO-related toxicities were minimal and transient. Postremission ATO therapy continued for 3 years; the most common side effect was ATO-induced neutropenia. With a median follow-up of 53 months (range, 23-76 months), the calculated 5-year overall survival and event-free survival were 83.9% and 72.7%, respectively, which are comparable with results achieved by the use of ATRA plus chemotherapy, which is the standard therapy for APL. No chronic arsenic toxicity or second malignancies were found during the follow-up period, and arsenic retention was not significant in patients off treatment more than 24 months. ATO resistance was observed in only 1 patient with a complex karyotype. The results indicate the high efficacy and safety of single-agent ATO regimens in the treatment of children with de novo APL.
Zhou
Jin
J
Department of Hematology, First Affiliated Hospital, Harbin Medical University, Harbin, China. zhoujin1111@126.com
Zhang
Yingmei
Y
Li
Jinmei
J
Li
Xiaoxia
X
Hou
Jinxiao
J
Zhao
Yanqiu
Y
Liu
Xiuhua
X
Han
Xueying
X
Hu
Longhu
L
Wang
Shuye
S
Zhao
Yanhong
Y
Zhang
Ying
Y
Fan
Shengjin
S
Lv
Chengfang
C
Li
Limin
L
Zhu
Lingling
L
D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007621:Karyotyping; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D009503:Neutropenia / Q000139:chemically induced; D010087:Oxides / Q000009:adverse effects / Q000627:therapeutic use*; D012074:Remission Induction; D013997:Time Factors
D000970:Antineoplastic Agents; D001152:Arsenicals; D010087:Oxides; D000077237:Arsenic Trioxide