title: [Stratification therapy in patients with acute promyelocytic leukemia after a complete remission by all-trans retinoic acid].
abstract: OBJECTIVE
  To explore an efficacious protocol for the patients with acute promyelocytic leukemia (APL) after a complete remission (CR) by all-trans retinoic acid (ATRA).
  
  
  METHODS
  A total of 32 APL patients with an induction of CR by ATRA at our hospital from January 2000 to October 2007 received conventional standard chemotherapy as a consolidation regimen. Stratified according to age, those under 50 years old received an intermediate dose of cytarabine(IDAra-C)and over 50 years old non-IDAra-C regimen. Maintenance regimen: all patients received ATRA, arsenic trioxide (As2O3) and 6-mercaptopurine (6-MP) + methotrexate (MTX) alternately and sequentially for 3 years. The efficacy and side effects of these chemotherapies were observed.
  
  
  RESULTS
  The median follow-up was 72 (40 - 124) months. The 5-year disease-free survival (DFS) rates of under 50 years old and over 50 years old were 94.7% and 92.3% respectively. The difference was statistically insignificant (P > 0.05). One patient relapsed after a consolidation therapy and so did another on a maintenance regimen. Thirty patients achieved a constant CR. And 16 of 30 patients completed chemotherapy beyond 5 years and survived disease-free. The 5-year DFS rate of 32 patients was 93.8%.
  
  
  CONCLUSIONS
  After the achievement of CR with ATRA, all APL patients have a higher rate of DFS after stratification. The side effects are generally mild. Thus a stratification therapy is both feasible and efficacious.
authors.affiliation: Department of Hematology, Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi, China.
authors.forename: Jian-li
authors.initials: JL
authors.lastname: Xu
authors.forename: Ming
authors.initials: M
authors.lastname: Jiang
authors.forename: Yasheng
authors.initials: Y
authors.lastname: Halida
authors.forename: Xian-lin
authors.initials: XL
authors.lastname: Duan
authors.forename: Xin-hong
authors.initials: XH
authors.lastname: Guo
authors.forename: Jian-ping
authors.initials: JP
authors.lastname: Hao
authors.forename: Mei-lan
authors.initials: ML
authors.lastname: Fu
authors.forename: Jian-hua
authors.initials: JH
authors.lastname: Qu
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014212:Tretinoin / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D014212:Tretinoin