Arsenic trioxide in comparison with chemotherapy and bone marrow transplantation for the treatment of relapsed acute promyelocytic leukaemia

Au, Wing Y.; Lie, Akw; Chim, Chor Sang; Liang, Raymond; K., S.; Chan, Colin; Mak, YK; Chen, Y. T.; So, C.C; Yeung, Yiu Ming; Yip, Sze Fai; Wong, Linda; Chan, Jane; Liu, S. Y.; Kwong, Yok–Lam

doi:10.1093/annonc/mdg208

Cited by 54 publications

(28 citation statements)

References 13 publications

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“…138,139 Confirmation of the high and sustained efficacy of ATO in patients with relapsed/refractory APL has been provided by more recent studies. [140][141][142][143][144] CR rates in these trials were 80% to 90% and, in those studies that evaluated survival, 50% to 70% of patients were alive at 1 to 3 years. Current evidence suggests that use of at least 2 cycles of ATO results in the achievement of second molecular CR in nearly 80% of cases.…”

Section: Hematologic Relapsementioning

confidence: 99%

Management of acute promyelocytic leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet

Sanz

Grimwade

Tallman

et al. 2009

Blood

846

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The introduction of all-trans retinoic acid (ATRA) and, more recently, arsenic trioxide (ATO) into the therapy of acute promyelocytic leukemia (APL) has revolutionized the management and outcome of this disease. Several treatment strategies using these agents, usually in combination with chemotherapy, but also without or with minimal use of cytotoxic agents, have provided excellent therapeutic results. Cure of APL patients, however, is also dependent on peculiar aspects related to the management and supportive measures that are crucial to counteract life-threatening complications associated with the disease biology and molecularly targeted treatment. The European LeukemiaNet recently appointed an international panel of experts to develop evidence-and expert opinion-based guidelines on the diagnosis and management of APL. Together with providing current indications on genetic diagnosis, modern risk-adapted front-line therapy and salvage treatment, the review contains specific recommendations for the identification and management of most important complications such as the bleeding disorder, APL differentiation syndrome, QT prolongation and other ATRAand ATO-related toxicities, as well as for molecular assessment of response to treatment. Finally, the approach to special situations is also discussed, including management of APL in children, elderly patients, and pregnant women.

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Section: Hematologic Relapsementioning

confidence: 99%

Management of acute promyelocytic leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet

Sanz

Grimwade

Tallman

et al. 2009

Blood

846

728

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“…Relapsed patients received an oral arsenic trioxide-based regimen. 10 In 31 APL patients, Wif-1 methylation was correlated with gender, age, and presentation white cell count. Categorical variables were compared by w 2 -test, and means of continuous variables (age and diagnostic leukocyte count) by Student t-tests.…”

mentioning

confidence: 98%

Preferential methylation of Wnt inhibitory factor-1 in acute promyelocytic leukemia: an independent poor prognostic factor

et al. 2006

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“…Several subsequent studies demonstrated similar results, with cr rates of 80%-100% and 2-year os rates ranging from 56% to 82% [27][28][29] . Overall, ato has been shown to be well tolerated, with most patients experiencing only mild toxic effects.…”

mentioning

confidence: 57%

A Canadian Consensus on the Management of Newly Diagnosed and Relapsed Acute Promyelocytic Leukemia in Adults

et al. 2014

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The use of all-trans-retinoic acid (ATRA) and anthracyclines (with or without cytarabine) in the treatment of acute promyelocytic leukemia (APL) has dramatically changed the management and outcome of the disease over the past few decades. The addition of arsenic trioxide (ATO) in the relapsed setting—and, more recently, in reduced-chemotherapy or chemotherapy-free approaches in the first-line setting—continues to improve treatment outcomes by reducing some of the toxicities associated with anthracycline-based approaches. Despite those successes, a high rate of early death from complications of coagulopathy remains the primary cause of treatment failure before treatment begins. In addition to that pressing issue, clarity is needed about the use of ATO in the first-line setting and the role of hematopoietic stem-cell transplantation (HSCT) in the relapsed setting. The aim for the present consensus was to provide guidance to health care professionals about strategies to reduce the early death rate, information on the indications for HSCT and on the use of ATO in induction and consolidation in low-to-intermediate–risk and high-risk APL patients.

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Arsenic trioxide in comparison with chemotherapy and bone marrow transplantation for the treatment of relapsed acute promyelocytic leukaemia

Abstract: Our results suggest that As(2)O(3) may be superior to chemotherapy and BMT for the treatment of APL in relapse.

Cited by 54 publications

References 13 publications

Management of acute promyelocytic leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet

Management of acute promyelocytic leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet

Preferential methylation of Wnt inhibitory factor-1 in acute promyelocytic leukemia: an independent poor prognostic factor

A Canadian Consensus on the Management of Newly Diagnosed and Relapsed Acute Promyelocytic Leukemia in Adults

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