Real-life experience of a brief arsenic trioxide-based consolidation chemotherapy in the management of acute promyelocytic leukemia: Favorable outcomes with limited anthracycline exposure and shorter consolidation therapy

Mindy Leech; Lawrence Morris; Moishe Stewart; B. Douglas Smith; Asad Bashey; Kent Holland; Scott Solomon; Xu Zhang; Hetty E. Carraway; Keith Pratz; Steven D. Gore; Amer M. Zeidan

doi:10.1016/j.clml.2014.11.001

Real-life experience of a brief arsenic trioxide-based consolidation chemotherapy in the management of acute promyelocytic leukemia: Favorable outcomes with limited anthracycline exposure and shorter consolidation therapy

Mindy Leech, Lawrence Morris, Moishe Stewart, B. Douglas Smith, Asad Bashey, Kent Holland, Scott Solomon, Xu Zhang, Hetty E. Carraway, Keith Pratz, Steven D. Gore, Amer M. Zeidan

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Abstract Background Anthracyclines have activity against acute promyelocytic leukemia (APL) but can cause cardiac toxicity and secondary malignancy. The all-trans retinoic acid (ATRA)-arsenic trioxide (ATO) combination is an effective noncytotoxic approach for APL. However, its efficacy against high-risk APL (white blood cell count > 10,000/μL) has not been documented. Also, it requires ≥ 8 months to complete therapy. Patients and Methods We report a retrospective analysis of 63 patients with APL given one cycle of ATO-based consolidation chemotherapy. Results The 5-year overall survival, event-free survival, and leukemia-free survival was 93% (95% confidence interval [CI], 82%-97%), 89% (95% CI, 77%-95%), and 92% (95% CI, 80%-97%), respectively. Conclusion These data have confirmed that an abbreviated ATO-based chemotherapy regimen is an effective consolidation therapy for APL, including high-risk APL, and can be completed within 4 months.

Original language	English (US)
Article number	520
Pages (from-to)	292-297
Number of pages	6
Journal	Clinical Lymphoma, Myeloma and Leukemia
Volume	15
Issue number	5
DOIs	https://doi.org/10.1016/j.clml.2014.11.001
State	Published - May 1 2015

Keywords

APL
ATO
All-trans retinoic acid
Anthracyclines
Promyelocytic leukemia-retinoic acid receptor α

ASJC Scopus subject areas

Hematology
Oncology
Cancer Research

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Leech, M., Morris, L., Stewart, M., Smith, B. D., Bashey, A., Holland, K., Solomon, S., Zhang, X., Carraway, H. E., Pratz, K., Gore, S. D., & Zeidan, A. M. (2015). Real-life experience of a brief arsenic trioxide-based consolidation chemotherapy in the management of acute promyelocytic leukemia: Favorable outcomes with limited anthracycline exposure and shorter consolidation therapy. Clinical Lymphoma, Myeloma and Leukemia, 15(5), 292-297. [520]. https://doi.org/10.1016/j.clml.2014.11.001

Real-life experience of a brief arsenic trioxide-based consolidation chemotherapy in the management of acute promyelocytic leukemia : Favorable outcomes with limited anthracycline exposure and shorter consolidation therapy. / Leech, Mindy; Morris, Lawrence; Stewart, Moishe; Smith, B. Douglas; Bashey, Asad; Holland, Kent; Solomon, Scott; Zhang, Xu; Carraway, Hetty E.; Pratz, Keith; Gore, Steven D.; Zeidan, Amer M.

In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 15, No. 5, 520, 01.05.2015, p. 292-297.

Research output: Contribution to journal › Article › peer-review

Leech, M, Morris, L, Stewart, M, Smith, BD, Bashey, A, Holland, K, Solomon, S, Zhang, X, Carraway, HE, Pratz, K, Gore, SD & Zeidan, AM 2015, 'Real-life experience of a brief arsenic trioxide-based consolidation chemotherapy in the management of acute promyelocytic leukemia: Favorable outcomes with limited anthracycline exposure and shorter consolidation therapy', Clinical Lymphoma, Myeloma and Leukemia, vol. 15, no. 5, 520, pp. 292-297. https://doi.org/10.1016/j.clml.2014.11.001

Leech M, Morris L, Stewart M, Smith BD, Bashey A, Holland K et al. Real-life experience of a brief arsenic trioxide-based consolidation chemotherapy in the management of acute promyelocytic leukemia: Favorable outcomes with limited anthracycline exposure and shorter consolidation therapy. Clinical Lymphoma, Myeloma and Leukemia. 2015 May 1;15(5):292-297. 520. https://doi.org/10.1016/j.clml.2014.11.001

Leech, Mindy ; Morris, Lawrence ; Stewart, Moishe ; Smith, B. Douglas ; Bashey, Asad ; Holland, Kent ; Solomon, Scott ; Zhang, Xu ; Carraway, Hetty E. ; Pratz, Keith ; Gore, Steven D. ; Zeidan, Amer M. / Real-life experience of a brief arsenic trioxide-based consolidation chemotherapy in the management of acute promyelocytic leukemia : Favorable outcomes with limited anthracycline exposure and shorter consolidation therapy. In: Clinical Lymphoma, Myeloma and Leukemia. 2015 ; Vol. 15, No. 5. pp. 292-297.

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abstract = "Abstract Background Anthracyclines have activity against acute promyelocytic leukemia (APL) but can cause cardiac toxicity and secondary malignancy. The all-trans retinoic acid (ATRA)-arsenic trioxide (ATO) combination is an effective noncytotoxic approach for APL. However, its efficacy against high-risk APL (white blood cell count > 10,000/μL) has not been documented. Also, it requires ≥ 8 months to complete therapy. Patients and Methods We report a retrospective analysis of 63 patients with APL given one cycle of ATO-based consolidation chemotherapy. Results The 5-year overall survival, event-free survival, and leukemia-free survival was 93% (95% confidence interval [CI], 82%-97%), 89% (95% CI, 77%-95%), and 92% (95% CI, 80%-97%), respectively. Conclusion These data have confirmed that an abbreviated ATO-based chemotherapy regimen is an effective consolidation therapy for APL, including high-risk APL, and can be completed within 4 months.",

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author = "Mindy Leech and Lawrence Morris and Moishe Stewart and Smith, {B. Douglas} and Asad Bashey and Kent Holland and Scott Solomon and Xu Zhang and Carraway, {Hetty E.} and Keith Pratz and Gore, {Steven D.} and Zeidan, {Amer M.}",

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AU - Stewart, Moishe

AU - Smith, B. Douglas

AU - Bashey, Asad

AU - Holland, Kent

AU - Solomon, Scott

AU - Zhang, Xu

AU - Carraway, Hetty E.

AU - Pratz, Keith

AU - Gore, Steven D.

AU - Zeidan, Amer M.

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PY - 2015/5/1

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N2 - Abstract Background Anthracyclines have activity against acute promyelocytic leukemia (APL) but can cause cardiac toxicity and secondary malignancy. The all-trans retinoic acid (ATRA)-arsenic trioxide (ATO) combination is an effective noncytotoxic approach for APL. However, its efficacy against high-risk APL (white blood cell count > 10,000/μL) has not been documented. Also, it requires ≥ 8 months to complete therapy. Patients and Methods We report a retrospective analysis of 63 patients with APL given one cycle of ATO-based consolidation chemotherapy. Results The 5-year overall survival, event-free survival, and leukemia-free survival was 93% (95% confidence interval [CI], 82%-97%), 89% (95% CI, 77%-95%), and 92% (95% CI, 80%-97%), respectively. Conclusion These data have confirmed that an abbreviated ATO-based chemotherapy regimen is an effective consolidation therapy for APL, including high-risk APL, and can be completed within 4 months.

AB - Abstract Background Anthracyclines have activity against acute promyelocytic leukemia (APL) but can cause cardiac toxicity and secondary malignancy. The all-trans retinoic acid (ATRA)-arsenic trioxide (ATO) combination is an effective noncytotoxic approach for APL. However, its efficacy against high-risk APL (white blood cell count > 10,000/μL) has not been documented. Also, it requires ≥ 8 months to complete therapy. Patients and Methods We report a retrospective analysis of 63 patients with APL given one cycle of ATO-based consolidation chemotherapy. Results The 5-year overall survival, event-free survival, and leukemia-free survival was 93% (95% confidence interval [CI], 82%-97%), 89% (95% CI, 77%-95%), and 92% (95% CI, 80%-97%), respectively. Conclusion These data have confirmed that an abbreviated ATO-based chemotherapy regimen is an effective consolidation therapy for APL, including high-risk APL, and can be completed within 4 months.

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