title: Single-agent arsenic trioxide in the treatment of children with newly diagnosed acute promyelocytic leukemia.
abstract: 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.
authors.affiliation: Department of Hematology, First Affiliated Hospital, Harbin Medical University, Harbin, China. zhoujin1111@126.com
authors.forename: Jin
authors.initials: J
authors.lastname: Zhou
authors.forename: Yingmei
authors.initials: Y
authors.lastname: Zhang
authors.forename: Jinmei
authors.initials: J
authors.lastname: Li
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Li
authors.forename: Jinxiao
authors.initials: J
authors.lastname: Hou
authors.forename: Yanqiu
authors.initials: Y
authors.lastname: Zhao
authors.forename: Xiuhua
authors.initials: X
authors.lastname: Liu
authors.forename: Xueying
authors.initials: X
authors.lastname: Han
authors.forename: Longhu
authors.initials: L
authors.lastname: Hu
authors.forename: Shuye
authors.initials: S
authors.lastname: Wang
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Zhao
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.forename: Shengjin
authors.initials: S
authors.lastname: Fan
authors.forename: Chengfang
authors.initials: C
authors.lastname: Lv
authors.forename: Limin
authors.initials: L
authors.lastname: Li
authors.forename: Lingling
authors.initials: L
authors.lastname: Zhu
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D001152:Arsenicals; D010087:Oxides; D000077237:Arsenic Trioxide