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

BackgroundAnthracyclines 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 MethodsWe report a retrospective analysis of 63 patients with APL given one cycle of ATO-based consolidation chemotherapy.ResultsThe 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.ConclusionThese 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.