Long-term therapeutic outcome of children with acute promyelocytic leukemia

Objectives To analyze the long-term therapeutic outcome of patients with acute promyelocytic leukemia(APL)in children.Methods All 17 APL patients were treated with all-trans retinoic acid(ATRA)as induction therapy until achieved complete remission(CR),together with chemotherapy or combined with arsenic induction and chemotherapy;followed by 3-5 courses of consolidation chemotherapy until PML-RARα fusion gene negative were proved.Then they received ATRA,As2O3,6-MP,MTX maintenance therapy.Total courses was 2 years.All patients were examined for bone marrow morphology,karyotype and PML-RARα fusion gene before,every three months after chemotherapy,and every three to six months after treatment was completed.Karyotype and PML-RARα fusion gene were analyzed by R-banding,and RT-PCR respectively.Results Among all the 17 patients,16(94%)patients achieved CR,12(70%)patients achieved continuous CR(CCR),The mean follow-up was 35(7-122)months.Four(4)patients relapsed(25%).Two of them showed continuous positive PML-RARα fusion gene and the other 2 patients transformed from negative into positive.Conclusions Most APL patients treated with serial therapy of combined ATRA and arsenic induction and chemotherapy can achieve a higher CCR,regularly cytogenetic detections can be regarded as an important marker for prognosis of APL.