title: Consolidation therapy of arsenic trioxide alternated with chemotherapy achieves remarkable efficacy in newly diagnosed acute promyelocytic leukemia.
abstract: BACKGROUND
  Currently, all-trans retinoic acid (ATRA) combined with daunorubicin and ATRA combined with arsenic trioxide (ATO) therapies are considered the standard induction therapy regimens for adult patients newly diagnosed with acute promyelocytic leukemia (APL). However, there is no consensus concerning the optimal consolidation and maintenance therapies after induction therapy. In this study, we explored a new therapeutic strategy for APL that may be simple, effective, and safe.
  
  
  METHODS
  The patients in our study were divided into high white blood cell (WBC) group and low WBC group according to the numeration of leukocytes at the first visit. The low WBC group received ATRA and ATO until complete remission (CR), and the high WBC group received anthracycline, ATRA, and ATO until CR. After achieving hematologic CR, ATO was alternated with chemotherapy for consolidation therapy. Three cycles were completed in the 1st year with no maintenance therapy. The patients were followed for a median of 5 years after their initial treatment.
  
  
  RESULTS
  After induction therapy, the rate of CR for the 18 patients was 100%. The rate of negativity for the PML/RARα fusion gene following induction therapy was 100%. There was no mortality during the treatment. Both the 5-year event-free survival rate and 5-year overall survival rate were 100%. No relapses occurred during the follow-up period.
  
  
  CONCLUSIONS
  This study proposes a novel treatment for APL that is efficient, well-tolerated, and very simple to perform.
authors.affiliation: Department of Hematological Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China ; Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Cheng-Cheng
authors.initials: CC
authors.lastname: Liu
authors.affiliation: Department of Hematological Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China ; Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Hematological Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China ; Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Wei-da
authors.initials: WD
authors.lastname: Wang
authors.affiliation: Department of Hematological Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China ; Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Meng-Yuan
authors.initials: MY
authors.lastname: Zhu
authors.affiliation: Department of Hematological Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China ; Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Qi-Rong
authors.initials: QR
authors.lastname: Geng
authors.affiliation: Department of Hematological Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China ; Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Lu
keywords: acute promyelocytic leukemia; all-trans retinoic acid; arsenic trioxide; consolidation therapy; new therapeutic strategy; survival