All-trans-retinoic acid, idarubicin, and IV arsenic trioxide as initial therapy in acute promyelocytic leukemia (APML4)
Harry J Iland, Ken Bradstock, Shane G Supple, Alberto Catalano, Marnie Collins, Mark Hertzberg, Peter Browett, Andrew Grigg, Frank Firkin, Amanda Hugman, John Reynolds, Juliana Di Iulio, Campbell Tiley, Kerry Taylor, Robin Filshie, Michael Seldon, John Taper, Jeff Szer, John Moore, John Bashford Show all
BLOOD | AMER SOC HEMATOLOGY | Published : 2012
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...View full abstract
The molecular monitoring was supported in part by a grant from the Leukaemia Foundation of Australia. Phebra provided ATO for the entire study.