All-transretinoic acid and chemotherapy in the treatment of acute promyelocytic leukemia.

Abstract

BACKGROUND:

All-transretinoic acid (ATRA) and chemotherapy has improved complete remission rates and disease free survival in acute promyelocytic leukemia (APL). There is scanty data from Middle East.

AIM:

To determine the efficacy of ATRA and multi-agent combination chemotherapy in treatment of APL in a single Centre in Kuwait. SET-UPS AND DESIGN: Tertiary cancer centre, retrospective study.

METHODS AND MATERIAL:

All newly diagnosed APL patients were treated with oral ATRA 45 mg/m2 daily until complete remission (CR), intravenous daunorubicin 50 mg/m2 on days 1,3 and 5, cytosine arabinoside 100 mg/m2 12 hrly on days 1 through 10 and etoposide 100 mg/m2 on days 1 through 5. Post remission three courses of intensive consolidation chemotherapy were administered. Since October 1999, maintenance chemotherapy consisting of oral 6 mercaptopurine 9 mg/m2 daily, methotrexate 15 mg/m2 weekly and ATRA 45 mg/m2 for 2 weeks every three months was added. Complete remission rates and duration, relapse rate and toxicity were studied.

RESULTS:

22 of 24 evaluable patients (91.6%) achieved CR. The median duration of remission was 13 months (range 2-55 months). Three patients (12.5%) relapsed. Two patients (8.3%) developed retinoic acid syndrome and responded to dexamethasone. Five patients (20.8%) died one each of refractory disease, during remission induction and of relapse. Two patients died while in remission.

CONCLUSION:

ATRA and combination chemotherapy results in high complete remission rates and low relapse rate in newly diagnosed APL. Maintenance therapy may be useful in preventing relapses.

• Authors: S Al Bahar, R Pandita, K Bavishi, O Kreze
• Journal: Indian journal of cancer (Indian J Cancer) 2004 Jul-Sep Vol. 41 Issue 3 Pg. 125-8 ISSN: 0019-509X [Print] India
• PMID: 15472411 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Cytarabine
• Tretinoin
• Etoposide
• Mercaptopurine
• Methotrexate
• Daunorubicin

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Cytarabine (administration & dosage)
• Daunorubicin (administration & dosage)
• Etoposide (administration & dosage)
• Female
• Humans
• Leukemia, Promyelocytic, Acute (drug therapy, pathology)
• Male
• Mercaptopurine (administration & dosage)
• Methotrexate (administration & dosage)
• Middle Aged
• Neoplasm Recurrence, Local (drug therapy, pathology)
• Remission Induction
• Retrospective Studies
• Treatment Outcome
• Tretinoin (administration & dosage)