title: Outcome of therapy-related acute promyelocytic leukemia with or without arsenic trioxide as a component of frontline therapy.
abstract: BACKGROUND
  Patients with therapy-related acute promyelocytic leukemia (t-APL) have been commonly exposed to topoisomerase inhibitors and may potentially benefit from induction regimens omitting anthracyclines.
  
  
  METHODS
  Retrospective analysis of the outcomes of 29 patients with t-APL who were either treated with arsenic trioxide (ATO) and all-trans-retinoic acid (ATRA) or with standard ATRA plus anthracycline-based chemotherapy was performed.
  
  
  RESULTS
  Prior therapy included chemotherapy alone, radiation alone, or a combination of the 2 in 19%, 33%, and 47% of patients, respectively. The combination of ATO and ATRA (n = 19) for induction resulted in a similar remission rate compared with ATRA plus chemotherapy (n = 10) (89% vs 70%; P = .35). The median overall survival for the patients treated with ATRA plus ATO was not reached compared with that for patients treated with ATRA plus chemotherapy (161 weeks; P = .79).
  
  
  CONCLUSIONS
  In this cohort of t-APL patients, outcomes with ATO and ATRA appeared to be comparable to anthracycline-containing induction regimens. This combination may be preferable in t-APL patients to avoid any risk of anthracycline-induced toxicities.
authors.affiliation: Department of Cancer Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Farshid
authors.initials: F
authors.lastname: Dayyani
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
authors.forename: Susan
authors.initials: S
authors.lastname: O'Brien
authors.forename: Sherry
authors.initials: S
authors.lastname: Pierce
authors.forename: Dan
authors.initials: D
authors.lastname: Jones
authors.forename: Stefan
authors.initials: S
authors.lastname: Faderl
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
authors.forename: Farhad
authors.initials: F
authors.lastname: Ravandi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000139:chemically induced* / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000188:drug therapy*; D010087:Oxides / Q000008:administration & dosage*; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D001152:Arsenicals; D010087:Oxides; D014212:Tretinoin; D000077237:Arsenic Trioxide
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