Analysis of Real-World Outcomes in Patients with Acute Promyelocytic Leukemia Treated with Arsenic Trioxide and All-trans Retinoic Acid without Chemotherapy.
10.19746/j.cnki.issn.1009-2137.2025.05.003
- Author:
Jia WANG
1
;
Qian-Shan TAO
1
;
Yi DONG
1
;
Zhi-Min ZHAI
1
Author Information
1. Department of Hematology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China.
- Publication Type:Journal Article
- Keywords:
acute promyelocytic leukaemia;
differentiation syndrome;
chemotherapy;
all-trans retinoic acid;
arsenic trioxide
- MeSH:
Humans;
Leukemia, Promyelocytic, Acute/drug therapy*;
Arsenic Trioxide/therapeutic use*;
Tretinoin/administration & dosage*;
Retrospective Studies;
Female;
Treatment Outcome;
Male;
Adult;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*;
Middle Aged;
Remission Induction
- From:
Journal of Experimental Hematology
2025;33(5):1254-1261
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the effect of non-chemotherapy strategy of retinoic acid (ATRA) combined with arsenic trioxide (ATO) on the survival of patients with acute promyelocytic leukemia (APL).
METHODS:The data of APL patients with complete information diagnosed in the hematology department of our hospital from June 2009 to November 2024 were retrospective analyzed. All patients in the non-CHT group received ATRA-ATO induction, consolidation and maintenance therapy. Patients in the CHT group received ATRA-ATO+chemotherapy induction therapy, followed by 3 cycles of ATRA-ATO+CHT consolidation therapy and 6-10 cycles of ATRA-ATO maintenance therapy. The primary endpoint was event-free survival (EFS). Secondary endpoints included overall survival (OS), remission rate, differentiation syndrome (DS) and safety.
RESULTS:There were 182 patients with APL and 15 patients with early death (ED), accounting for 8.24%, which was related to age and risk stratification. There was no significant difference in remission rate between the non-CHT group and the CHT group (P =0.486). As of February 2025, the median follow-up time of patients was 39.5 months. The EFS of the non-CHT group was significantly better than that of the CHT group (P =0.038). There was no significant difference in OS between the two groups (P =0.442). Subgroup analysis showed that EFS in the non-CHT was longer in standard-risk patients (P =0.012). There was no significant difference in EFS (P =0.585) and OS (P =0.473) between the CHT and non-CHT groups in high-risk patients. The incidence of mild DS was 23.6% in the non-CHT group and 23.1% in the CHT group, respectively, with no statistically significant difference(P =0.937). Compared with CHT group, the incidence of serious adverse events was lower in the non-CHT group.
CONCLUSION:The non-chemotherapy regimen of ATRA combined with ATO is a feasible method to cure APL patients.
