Journal article
All-trans-retinoic acid, idarubicin, and IV arsenic trioxide as initial therapy in acute promyelocytic leukemia (APML4)
HJ Iland, K Bradstock, SG Supple, A Catalano, M Collins, M Hertzberg, P Browett, A Grigg, F Firkin, A Hugman, J Reynolds, J Di Iulio, C Tiley, K Taylor, R Filshie, M Seldon, J Taper, J Szer, J Moore, J Bashford Show all
Blood | Published : 2012
Abstract
The treatment of acute promyelocytic leukemia has improved considerably after recognition of the effectiveness of all trans-retinoic acid (ATRA), anthracycline-based chemotherapy, and arsenic trioxide (ATO). Here we report the use of all 3 agents in combination in an APML4 phase 2 protocol. For induction, ATO was superimposed on an ATRA and idarubicin backbone, with scheduling designed to exploit antileukemic synergy while minimizing cardiotoxicity and the severity of differentiation syndrome. Consolidation comprised 2 cycles of ATRA and ATO without chemotherapy, followed by 2 years of maintenance with ATRA, oral methotrexate, and 6-mercaptopurine. Of 124 evaluable patients, there were 4 (3...
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Funding Acknowledgements
The molecular monitoring was supported in part by a grant from the Leukaemia Foundation of Australia. Phebra provided ATO for the entire study.