title: [Outcome of acute promyelocytic leukemia with homoharringtonine (HHT) and ATRA].
abstract: OBJECTIVE
  To assess complete remission (CR), the overall survival (OS), event-free survival (EFS) and adverse events of newly diagnosed acute promyelocytic leukemia (APL) with homoharringtonine (HHT) plus ATRA, to evaluate the therapeutic effect by comparing HHT plus ATRA with daunorubicin plus ATRA as induction regimen (HA with DA as post-remission regimen).
  
  
  METHODS
  115 APL patients (54 in HHT group, 61 in DNR group) after long-term follow-up were enrolled in the analyses of clinical feature, chromosome karyotype, molecular biology, OS and EFS.
  
  
  RESULTS
  The overall CR of 115 patients was 100%, the median interval to achieve hematological CR was 32 (22 - 43) days, the overall median OS was within 0.23 - 77.34 months, median EFS was within 0.23 - 77.34 months. 3-year OS rate was 93%, 5-year OS rate 93%, 3-year EFS rate 85% and 5-year RFS rate 75% respectively. Converting to PML-RARα PCR-negative after the induction therapy in the HHT and DNR group was 31.3% and 15.5% respectively, at the end of 1 consolidation course was 68.6% and 77.6% respectively, while the remaining 4 patients tested PML-RARα PCR-negative at the end of 2 consolidation courses in the DNR group. While both groups obtained the identical molecular biology relapse rate (9.8% and 8.6%, respectively). Survival analysis indicated that no significant difference was found on OS and EFS between the HHT group and the DNR group (P = 0.206 and 0.506). 5-year OS rate was 87% for the HHT group while 98% for the DNR group, 5-years EFS rate was 80% for the HHT group while 71% for the DNR group. And the risk group was not the factor affecting OS and EFS (P = 0.615 and 0.416). Grade 2 fever in the HHT group was less than in the DNR group during induction therapy. And no difference was found in terms of liver dysfunction, renal dysfunction, cardiac dysfunction, and hematologic toxicity between two groups.
  
  
  CONCLUSIONS
  Our study demonstrated comparable therapeutic effect of HHT or DNR on APL. HHT was also well tolerated and didn't cause serious adverse events.
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, Tianjin, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Yuan
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Dong
authors.initials: D
authors.lastname: Lin
authors.forename: Ying-chang
authors.initials: YC
authors.lastname: Mi
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Hui
authors.initials: H
authors.lastname: Wei
authors.forename: Bing-cheng
authors.initials: BC
authors.lastname: Liu
authors.forename: Chun-lin
authors.initials: CL
authors.lastname: Zhou
authors.forename: Kai-qi
authors.initials: KQ
authors.lastname: Liu
authors.forename: Jin-Yu
authors.initials: JY
authors.lastname: Wang
authors.forename: Shu-ning
authors.initials: SN
authors.lastname: Wei
authors.forename: Ben-Fa
authors.initials: BF
authors.lastname: Gong
authors.forename: Xing-Li
authors.initials: XL
authors.lastname: Zhao
authors.forename: Ming-yuan
authors.initials: MY
authors.lastname: Sun
authors.forename: Jian-xiang
authors.initials: JX
authors.lastname: Wan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006248:Harringtonines / Q000008:administration & dosage; D000077863:Homoharringtonine; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D006248:Harringtonines; D014212:Tretinoin; D000077863:Homoharringtonine