title: Treatment of relapsed acute promyelocytic leukemia by arsenic trioxide in Iran.
abstract: BACKGROUND
  Although standard first line treatment of acute promyelocytic leukemia is All trans retinoic acid (ATRA) and chemotherapy, some patients relapse and need a second line of treatment. Relapsed cases of promyelocytic leukemia can be salvaged with arsenic trioxide.
  
  
  METHODS
  Between May 1999 and Jan. 2010, we treated 31 relapsed cases of promyelocytic leukemia with arsenic trioxide. These cases relapsed after previous treatment with ATRA and chemotherapy. We applied arsenic trioxide as 0.15 mg/kg iv infusion until complete remission. After achieving complete remission patients received 2-4 consolidation therapy in the same schedule as remission induction.
  
  
  RESULTS
  The median age of patients was 27 years. Complete remission rate was 77.4%. We observed four mortalities during remission induction. With a median follow up of 32 months, ten more relapses occurred. Two year disease-free survival and overall survival for the entire cohort was 54.6% and 81.1%, respectively.
  
  
  CONCLUSIONS
  Our result is the same as other studies. Thus, we suggest that arsenic trioxide can be used as salvage therapy in patients who relapsed. Despite a good complete remission rate, the relapse rate during the first two years of treatment is high and hematopoietic stem cell transplantation should be considered after achieving complete remission.
authors.affiliation: Hematology, Oncology and Stem Cell Transplantation Research Center of Tehran University of Medical Sciences, Tehran, Iran. alimgh@ams.ac.ir
authors.forename: Kamran
authors.initials: K
authors.lastname: Alimoghaddam
authors.forename: Ardeshir
authors.initials: A
authors.lastname: Ghavamzadeh
authors.forename: Mohamad
authors.initials: M
authors.lastname: Jahani
authors.forename: Asadolah
authors.initials: A
authors.lastname: Mousavi
authors.forename: Masoud
authors.initials: M
authors.lastname: Iravani
authors.forename: Shahrbano
authors.initials: S
authors.lastname: Rostami
authors.forename: Hamidolah
authors.initials: H
authors.lastname: Ghaffari
authors.forename: Roholah
authors.initials: R
authors.lastname: Hosseini
authors.forename: Mehdi
authors.initials: M
authors.lastname: Jalili
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000627:therapeutic use*; D002648:Child; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007492:Iran; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality; D010087:Oxides / Q000627:therapeutic use*; D012074:Remission Induction; D016879:Salvage Therapy; D016896:Treatment Outcome; D014212:Tretinoin / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001152:Arsenicals; D010087:Oxides; D014212:Tretinoin; D000077237:Arsenic Trioxide