[Clinical investigation of homoharringtonine in combination with all-transretinoic acid and arsenic trioxide for acute promyelocytic leukemia].

Abstract

OBJECTIVE:

To study the clinical outcome, adverse effect and treatment cost of homoharringtonine (HHT) in combination with all-trans retinoic acid (ATRA) and arsenic trioxide (AS2O3) for newly diagnosed with patients acute promyelocytic leukemia (APL).

METHODS:

Clinical data of treatment of newly diagnosed patients with APL in experimental group (HHT + ATRA + AS2O3, n = 14) and control group \[Idarubicin (IDA) + ATRA + AS2O3, n = 21\] were analyzed retrospectively. The therapeutic effects, side effects and costs during induction therapy were compared between the two groups.

RESULTS:

(1) The complete remission (CR) rate were 92.9% (13/14) and 95.2% (20/21) in experimental group and control group, respectively. The time to achieve CR were (28.1 ± 3.8) and (31.7 ± 4.2) days, respectively (P > 0.05). The negative rate of PML-RARα fusion gene at the time of CR were 76.9% (10/13) and 75.0% (15/20), respectively, and that in CR patient at the end of the first cycle treatment were 100.0% (13/13) and 95.0% (19/20), respectively (P > 0.05). (2) 5-year overall survival (OS) rate were (92.6 ± 0.6)% and (89.9 ± 0.5)%, respectively (P > 0.05), 5-year disease free survival (DFS) rate were 100.0% and (86.8 ± 0.6)%, respectively (P > 0.05). (3) During induction therapy, the incidence of infection in experimental and control group were 23.1% (3/13), 60.0% (12/20), respectively (P < 0.05). The amount of platelet transfusion were (54.7 ± 29.6) and (76.5 ± 25.6) units, respectively (P > 0.05), and that of fresh frozen plasma were (1157.1 ± 238.4) and (1423.5 ± 324.6) ml, respectively (P > 0.05). The total medical costs (excluding HHT and IDA) in experimental and control group were (36074.9 ± 1245.6) and (50564.5 ± 3658.4)CNY, respectively (P < 0.05).

CONCLUSION:

HHT in combination with ATRA and AS2O3 regimen for newly diagnosed APL has a better efficacy, a higher long-term survival rate, and a lower costs, which is one of the reasonable choice.

• Authors: Ren-zhi Pei, Shuang-yue Li, Pei-sheng Zhang, Jun-xia Ma, Xu-hui Liu, Xiao-hong Du, Dong Chen, Ke-ya Sha, Lie-guang Chen, Jun-jie Cao, Xian-xu Zhuang, Jing-yi Wu, Li Lin, Zheng Fan, Pei-pei Ye, Shan-hao Tang, Bi-bo Zhang, Xiao-wei Shi
• Journal: Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi (Zhonghua Xue Ye Xue Za Zhi) Vol. 34 Issue 2 Pg. 144-8 (Feb 2013) ISSN: 0253-2727 [Print] China
• PMID: 23611222 (Publication Type: Controlled Clinical Trial, Journal Article, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Arsenicals
• Harringtonines
• Oxides
• Tretinoin
• Homoharringtonine
• Arsenic Trioxide

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Arsenic Trioxide
• Arsenicals (therapeutic use)
• Female
• Harringtonines (therapeutic use)
• Homoharringtonine
• Humans
• Leukemia, Promyelocytic, Acute (drug therapy)
• Male
• Middle Aged
• Oxides (therapeutic use)
• Retrospective Studies
• Treatment Outcome
• Tretinoin (therapeutic use)