Clinical observation of acute promyelocytic leukemia remission induction and sequential treatment programs

Objective To observe efficacy of acute promyelocytic leukemia (APL) by chemotherapy induction and treatment programs after remission.Methods 28 cases of newly diagnosed APL were treated with combined arsenic trioxide and retinoic acid which was called induced program,the patients whose leukocytes ＞10×109/L would be given anthracycline chemotherapy (DNR 40 mg × 3 d).Remission induction anthracycline chemotherapy was given after three courses of intensive therapy,the standard-dose cytarabine was used to the patients with high white blood.After the intensive treatment and with the recorery of the patient' s blood,bone marrow sequential therapy was used [arsenic trioxide (As2O3),retinoic acid (ATRA),6-MP + MTX and chemotherapy],during which recurrence rate and adverse reactions in the patient' s course of treatment were observed.Results Except 1 was died of intracranial hemorrhage at the beginning of treatment,the remaining 27 patients had received hematologic remission with PML/RARα fusion gene negative.Fusion gene of 5 patients remained negative even after maintenance treatment 2 years later.Conclusion As2O3,ATRA combined with chemotherapy in the treatment of APL is effective,the hematologic response time may be shortened,and sequential therapy can significantly reduce the relapse rate and hospitalization time,patient compliance is increased and the quality of life in patients is improved. Key words: Leukemia, promyelocytic, acute;  Arsenic trioxide;  Retinoic acid;  Drug therapy,combination