title: Real-life experience of a brief arsenic trioxide-based consolidation chemotherapy in the management of acute promyelocytic leukemia: favorable outcomes with limited anthracycline exposure and shorter consolidation therapy.
abstract: BACKGROUND
  Anthracyclines have activity against acute promyelocytic leukemia (APL) but can cause cardiac toxicity and secondary malignancy. The all-trans retinoic acid (ATRA)-arsenic trioxide (ATO) combination is an effective noncytotoxic approach for APL. However, its efficacy against high-risk APL (white blood cell count > 10,000/μL) has not been documented. Also, it requires ≥ 8 months to complete therapy.
  
  
  METHODS
  We report a retrospective analysis of 63 patients with APL given one cycle of ATO-based consolidation chemotherapy.
  
  
  RESULTS
  The 5-year overall survival, event-free survival, and leukemia-free survival was 93% (95% confidence interval [CI], 82%-97%), 89% (95% CI, 77%-95%), and 92% (95% CI, 80%-97%), respectively.
  
  
  CONCLUSIONS
  These data have confirmed that an abbreviated ATO-based chemotherapy regimen is an effective consolidation therapy for APL, including high-risk APL, and can be completed within 4 months.
authors.affiliation: Blood and Marrow Transplant Program, Northside Hospital, Atlanta, GA.
authors.forename: Mindy
authors.initials: M
authors.lastname: Leech
authors.affiliation: Blood and Marrow Transplant Program, Northside Hospital, Atlanta, GA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Morris
authors.affiliation: Department of Oncology, Johns Hopkins University, Baltimore, MD.
authors.forename: Moishe
authors.initials: M
authors.lastname: Stewart
authors.affiliation: Department of Oncology, Johns Hopkins University, Baltimore, MD.
authors.forename: B Douglas
authors.initials: BD
authors.lastname: Smith
authors.affiliation: Blood and Marrow Transplant Program, Northside Hospital, Atlanta, GA.
authors.forename: Asad
authors.initials: A
authors.lastname: Bashey
authors.affiliation: Blood and Marrow Transplant Program, Northside Hospital, Atlanta, GA.
authors.forename: Kent
authors.initials: K
authors.lastname: Holland
authors.affiliation: Blood and Marrow Transplant Program, Northside Hospital, Atlanta, GA.
authors.forename: Scott
authors.initials: S
authors.lastname: Solomon
authors.affiliation: Department of Mathematics and Statistics, Georgia State University, Atlanta, GA.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Leukemia Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.
authors.forename: Hetty E
authors.initials: HE
authors.lastname: Carraway
authors.affiliation: Department of Oncology, Johns Hopkins University, Baltimore, MD.
authors.forename: Keith
authors.initials: K
authors.lastname: Pratz
authors.affiliation: Section of Hematology, Department of Internal Medicine, Yale University, New Haven, CT.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Gore
authors.affiliation: Section of Hematology, Department of Internal Medicine, Yale University, New Haven, CT. Electronic address: amer.zeidan@yale.edu.
authors.forename: Amer M
authors.initials: AM
authors.lastname: Zeidan
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000627:therapeutic use*; D060830:Consolidation Chemotherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010087:Oxides / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D001152:Arsenicals; D010087:Oxides; D000077237:Arsenic Trioxide
keywords: APL; ATO; All-trans retinoic acid; Anthracyclines; Promyelocytic leukemia-retinoic acid receptor α