Clinical observation of the combination of all-trans retinoic acid with arsenic trioxide on newly-diagnosed patients of acute promyelocytic leukemia

Objective:To observe the therapeutic efficacy and side effect of all-trans retinoic acid(ATRA) combined with arsenic trioxide(As2O3)on newly-diagnosed patients with acute promyelocytic leukemia(APL).Method:55 patients of newly-diagnosed APL,underwent ATRA +As2O3 therapy. The therapeutic effect was compared with ATRA alone treatment on 31 patients and that of As2O3 alone treatment on 26 patients. The combination group were treated with ATRA 25 mg·m-2·d-1 and As2O3 0.16 mg·kg-1·d-1 until complete remission(CR). The dose were adjusted according to white blood cell(WBC) counts and side effect. CR rate,period to CR,incidence of early death and side effect were observed in three groups.Result:There was no significantly difference in CR rate among the three groups (96.3% for ATRA +As2O3 group,83.9% for ATRA group and 84.6% for As2O3 group respectively,P0.05). In compared with ATRA and As2O3 respectively,the combination group shortened the period to CR (the medium time to CR was 25 days for the ATRA +As2O3 group,47days for ATRA group and 41 days for As2O3 group respectively,P0.05). The combination group showed a lowed incidence of early death (3.6% for ATRA +As2O3 group,12.9% for ATRA group and 11.5% for As2O3 group respectively,P0.05). The combined use of ATRA with As2O3 did not further enhance toxic side effect as compared to ATRA alone or As2O3 alone.Conclusion:ATRA +As2O3 regiment is superior to either regiment given alone to patients with APL. It is an efficient therapeutic approach to APL patients using a combination of ATRA with As2O3.