What is the efficacy of arsenic trioxide with all-trans-retinoic acid (ATRA) for the treatment of acute promyelocytic leukemia (APL)?

Updated: May 26, 2020
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

More recent trials have studied regimens utilizing ATRA plus arsenic trioxide without chemotherapy. Lo-Coco et al conducted a phase III randomized trial of ATRA plus chemotherapy verus ATRA plus arsenic trioxide in patients with APL classified as low-to-intermediate risk (WBC ≤10 x 109/L). Complete remission was achieved in 100% of patients in the ATRA-arsenic group and 95% of the ATRA-chemotherapy group. Two-year event-free survival rates were 97% for ATRA-arsenic and 86% for ATRA-chemotherapy group. Overall survival was better with ATRA-arsenic trioxide, largely due to a reduction in cytopenic deaths. Longer follow-up is needed to determine if long term cure rates will be the same. [96]


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