Clinical analysis of the treatment with combination of all-trans retinoic acid and arsenic trioxide in newly diagnosed acute promyelocytic leukemia

Objective To study whether all-trans retinoic acid with arsenic trioxide in acute promyelocytic leukemia treatment could further improve the clinical and molecular remission rate.Methods 46 cases of firty newly-diagnosed APL patients entered into the study.They were divided into observing group and control group.24 cases of patients were treated with ATRA combined with As2O3 until complete remission,the doses were adjusted according to white blood cell counts,occurrence of RA syndrome and 22 cases of patients were treated with ATRA until CR,the status of liver function.CR rate,time of reaching clinical and side effects were observed.Result Firty six newly-diagnosed APL patients,The observing group CR rate wsa 95.8%,the control group CR rate was 77.3%.Hyperleukocytosis emerged in 65.0% and hepatic damages in 63.8% of the patients,they were ameliorated within one week after reduction of the As2O3 dose or its suspension.The PMLRARαfusion gene that was positive in all 29 patients before treatment turned negative only in 3 cases(9.8%)after obtaining CR(CR1).Conclusion ATRA combined with As2O3 in de novo APL treatment can yield a high CR rate without intolerable side effects.Long term effect needs further observation.