OBJECTIVETo investigate the remission rate of all-transretinoic acid (ATRA) combined with arsenics acid(ATO) on acute promyelocytic leukemia, and the efficacy and safety of sequential consolidation therapy with idarubicin, all-trans retinoic acid and arsenic trioxide/compound Huangdai tablet.

METHODSBetween January 2011 and January 2016 years 22 patients with newly diagnosed acute promyelocytic leukemia who received ATRA combined with ATO till complete remission in our hospital were retrospectively analyzed. Rates of CR, early mortality, complications and duration of induction were analyzed. The low/intermediate risk patients received 1-2 courses of idarubicin (IDA) single-agent chemotherapy, ATRA and compound Huangdai tablet /ATO alternative treatment of 4 cycles after complete remission; the high-risk patients received idarubicin and cytarabine chemotherapy, ATRA and compound Huangdai tablet /ATO alternative treatment of a total of 4 cycles for double-induction group.

RESULTSDouble-induction achieved a 100% CR rates after 28.23±1.6 days induction. During induction, the infection rate was 50%, 36.4% of patients had differentiation syndrome and 27.3% suffered from bleeding in different locations. The 5-year overall survival was 100% and relapse-free survival was 95.4%.

CONCLUSIONThis protocol has a good antileukemic effect. The combination of ATRA and ATO achieves extremely high complete reminssion rate and reduces coagulopathy to cut down early mortality. Sequential therapy with IDA, ATRA, and ATO as a consolidation regimen results in satisfactory clinical outcomes with tolerable side effects.