title: [Clinical investigation of homoharringtonine in combination with all-transretinoic acid and arsenic trioxide for acute promyelocytic leukemia].
abstract: OBJECTIVE
  To study the clinical outcome, adverse effect and treatment cost of homoharringtonine (HHT) in combination with all-trans retinoic acid (ATRA) and arsenic trioxide (AS2O3) for newly diagnosed with patients acute promyelocytic leukemia (APL).
  
  
  METHODS
  Clinical data of treatment of newly diagnosed patients with APL in experimental group (HHT + ATRA + AS2O3, n = 14) and control group \[Idarubicin (IDA) + ATRA + AS2O3, n = 21\] were analyzed retrospectively. The therapeutic effects, side effects and costs during induction therapy were compared between the two groups.
  
  
  RESULTS
  (1) The complete remission (CR) rate were 92.9% (13/14) and 95.2% (20/21) in experimental group and control group, respectively. The time to achieve CR were (28.1 ± 3.8) and (31.7 ± 4.2) days, respectively (P > 0.05). The negative rate of PML-RARα fusion gene at the time of CR were 76.9% (10/13) and 75.0% (15/20), respectively, and that in CR patient at the end of the first cycle treatment were 100.0% (13/13) and 95.0% (19/20), respectively (P > 0.05). (2) 5-year overall survival (OS) rate were (92.6 ± 0.6)% and (89.9 ± 0.5)%, respectively (P > 0.05), 5-year disease free survival (DFS) rate were 100.0% and (86.8 ± 0.6)%, respectively (P > 0.05). (3) During induction therapy, the incidence of infection in experimental and control group were 23.1% (3/13), 60.0% (12/20), respectively (P < 0.05). The amount of platelet transfusion were (54.7 ± 29.6) and (76.5 ± 25.6) units, respectively (P > 0.05), and that of fresh frozen plasma were (1157.1 ± 238.4) and (1423.5 ± 324.6) ml, respectively (P > 0.05). The total medical costs (excluding HHT and IDA) in experimental and control group were (36074.9 ± 1245.6) and (50564.5 ± 3658.4)CNY, respectively (P < 0.05).
  
  
  CONCLUSIONS
  HHT in combination with ATRA and AS2O3 regimen for newly diagnosed APL has a better efficacy, a higher long-term survival rate, and a lower costs, which is one of the reasonable choice.
authors.affiliation: Department of Hematology, Yinzhou People's Hospital, Ningbo 315040, China.
authors.forename: Ren-zhi
authors.initials: RZ
authors.lastname: Pei
authors.forename: Shuang-yue
authors.initials: SY
authors.lastname: Li
authors.forename: Pei-sheng
authors.initials: PS
authors.lastname: Zhang
authors.forename: Jun-xia
authors.initials: JX
authors.lastname: Ma
authors.forename: Xu-hui
authors.initials: XH
authors.lastname: Liu
authors.forename: Xiao-hong
authors.initials: XH
authors.lastname: Du
authors.forename: Dong
authors.initials: D
authors.lastname: Chen
authors.forename: Ke-ya
authors.initials: KY
authors.lastname: Sha
authors.forename: Lie-guang
authors.initials: LG
authors.lastname: Chen
authors.forename: Jun-jie
authors.initials: JJ
authors.lastname: Cao
authors.forename: Xian-xu
authors.initials: XX
authors.lastname: Zhuang
authors.forename: Jing-yi
authors.initials: JY
authors.lastname: Wu
authors.forename: Li
authors.initials: L
authors.lastname: Lin
authors.forename: Zheng
authors.initials: Z
authors.lastname: Fan
authors.forename: Pei-pei
authors.initials: PP
authors.lastname: Ye
authors.forename: Shan-hao
authors.initials: SH
authors.lastname: Tang
authors.forename: Bi-bo
authors.initials: BB
authors.lastname: Zhang
authors.forename: Xiao-wei
authors.initials: XW
authors.lastname: Shi
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000627:therapeutic use; D005260:Female; D006248:Harringtonines / Q000627:therapeutic use; D000077863:Homoharringtonine; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010087:Oxides / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome; D014212:Tretinoin / Q000627:therapeutic use
chemical_list: D001152:Arsenicals; D006248:Harringtonines; D010087:Oxides; D014212:Tretinoin; D000077863:Homoharringtonine; D000077237:Arsenic Trioxide