Clinical Observation and Follow up of Acute Promyelocytic Leukemia in Children Treated with Arsenic Trioxide

Objective To study the clinical efficacy of acute promyelocytic leukemia(APL)in children with arsenic trioxide(As2O3) of therapeutic dose.Methods Twenty-one children with APL were treated in 7 years with As2O3 to induce,consolidate and maintain.The induce dose was 0.15-0.33 mg/(kg·d),total induce dose was 45-720 mg.The time of induction was 30-106 days.Course of treatment was 2 to 3 years.Adverse effects were observed.Duration of follow up was 5-88 months.Results The complete remission(CR) were 13 cases(61.9%),partial remission(PR) were 7 cases(33.3%) and non remission(NR) were 1 case for the previously untreated group.During the treatment none of the 21children was dead,relapse rate was 9.5% and disease free survival was 85.7%.Eighteen cases were in complete remission,12 of them had stopped taking drugs for 1 to 51 months.Eight cases had the fusion gene detection,all of them were negative.The main adverse effect included gastric-intestinal reaction,hepatic demage,high white blood cell syndrome and so on.There were mild side effects,which were tolerant.Extramedullary leukemia was not occurred.Conclusions The CR rate and long-term survival are high and the relapse rate is low in APL children treated with As2O3.It can also be used separately in maintenance treatment.As2O3 is a more ideally agent treating APL in children at present.