The clinical observation of all-trans retinoic acid and arsenic trioxide combined with chemotherapy in the treatment of newly diagnosed acute promyelocytic leukemia

Objective To analyze the therapeutic effect of double-induction all-trans retinoic acid(ATRA) and arsenic trioxide(ATO) combined with chemotherapy for the newly diagnosed patients with acute promyelocytic leukemia(APL).Methods Thirty five newly diagnosed APL patients were treated with ATRA and ATO combining with daunorubicin and cytarabine(DA) regimen as induction therapy.The postremission therapy was sequential therapy consisting of DA,MA(mitroxantrone and cytarabine),HA(harringtonine and cytarabine),MDAra-c(middle dose cytarabine) and ATO,ATRA was administered to the patients orally after each cycle of chemotherapy.The overall treatment course was 3 years.Results Except for 1 patient died of intracranial hemorrhage at the early time of induction, 33 of 34 cases(97.1%) achieved CR and 1 case(2.9%) died of severe pulmonary infection.2 cases (5.9%) of 34 patients developed the retinoic acid syndrome during induction.Follow up at the time May,2009, there were 2 cases recurred.The 3-year overall survival rate and free survival rate were 94.12%and 91.18%respectively. Conclusion For newly diagnosed patients with APL,the double induction ATRA and ATO combined with chemotherapy was highly effective and well tolerated.