Efficacy of Arsenic Trioxide in the Treatment of Newly Diagnosed Acute Promyelocytic Leukemia: A 10-year Period Outcome

Abstract

Background and Objective :Acute promyelocytic leukemia (APL) is characterized by hyperproliferation of promyelocytes along with arrest of further maturation. All-trans retinoic acid (ATRA) plus chemotherapy is the standard treatment for APL with more than 80% remission rate. Arsenic trioxide (As₂O₃) is an alternative treatment for APL in both new and relapsed APL cases. Head to head comparison date between these two treatment regimen are limited. This study aimed to compare the effectiveness of both treatment regimens for APL.

Methods : We conducted a retrospective study of all newly diagnosed APL cases at Khon Kaen Hospital from June 2002 through May 2012. Eligible patients were divided into two groups; ATRA plus Idarubicin or arsenic trioxide. The study was to evaluate whether the complete remission between both groups were not different.

Results :During the study period, there were 45 patients treated with ATRA plus Idarubicin and 16 patients treated with arsenic trioxide. The complete remission rate was 84% (38 patients) in ATRA plus chemotherapy group and 81% (13 patients) in arsenic trioxide group. The two-year disease-free survival (DFS) rate was 71% in the ATRA plus chemotherapy group and 69% in the arsenic trioxide group. The two-year relapse was 9 months in the ATRA plus chemotherapy group and 8 months in the arsenic trioxide group. The overall survival duration was 27 months in the ATRA plus chemotherapy group and 26 months in the arsenic trioxide group after three years of follow-up.

Conclusions : Arsenic trioxide treatment is not different from ATRA plus Idarubicin for newly diagnosed APL in terms of complete remission rate.