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学科主题: 临床医学
题名:
Long-term prognosis of childhood acute promyelocytic leukaemia with arsenic trioxide administration in induction and consolidation chemotherapy phases: a single-centre experience
作者: Cheng, Yifei; Zhang, Leping; Wu, Jun; Lu, Aidong; Wang, Bin; Liu, Guilan
关键词: children ; acute promyelocytic leukaemia ; As2O3 ; induction chemotherapy ; consolidation chemotherapy
刊名: EUROPEAN JOURNAL OF HAEMATOLOGY
发表日期: 2013-12-01
DOI: 10.1111/ejh.12194
卷: 91, 期:6, 页:483-489
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Hematology
研究领域[WOS]: Hematology
关键词[WOS]: TRANS-RETINOIC ACID ; REMISSION INDUCTION ; CHILDREN ; THERAPY ; COMBINATION ; EFFICACY ; PROTOCOL
英文摘要:

ObjectivesThe efficacy of all-trans retinoic acid (ATRA) and arsenic trioxide (As2O3) as induction therapy for adult acute promyelocytic leukaemia (APL) has been documented in several clinical trials. However, the role of ATRA/As2O3 combination in induction and consolidation therapy in children remains unclear. Here, we report the efficacy of combined treatment with As2O3 and ATRA as induction and consolidation chemotherapy to treat newly diagnosed childhood APL.

MethodsFrom 1998 to 2011, 43 children with newly diagnosed APL received induction and consolidation chemotherapy with ATRA and As2O3 (Protocol B). Rates of complete remission (CR), event-free survival (EFS), disease-free survival (DFS), and overall survival (OS) and drug toxicity were compared between children treated with Protocol B and 25 others treated previously with ATRA alone as induction chemotherapy (Protocol A).

ResultsOf 43 patients treated with Protocol B, 41 (95.4%) achieved CR (two died of intracranial haemorrhage on day 10 and 14). In contrast, only 20 (80%) of 25 patients treated with Protocol A achieved CR. Thus, the CR rate was significantly lower in patients receiving induction chemotherapy with Protocol A than in those treated with Protocol B (P=0.045, (2)=6.508). Of the 41 patients who achieved CR on induction therapy with Protocol B, 40 also received consolidation therapy. Molecular relapse, but no overt morphological relapse, occurred in one patient at 25months after diagnosis; this patient regained CR status with As2O3 treatment. With a median follow-up period of 75months, estimated EFS, DFS and OS rates were 92.54.2%, 97.1 +/- 2.9% and 95.3 +/- 3.2%, respectively, for Protocol B. In contrast, with a median follow-up of 127months, the EFS, DFS and OS rates at 75months were 70.4 +/- 9.4%, 76.4 +/- 9.2% and 70.4 +/- 9.4%, respectively, for Protocol A. Thus, patients treated with Protocol A showed significantly lower EFS (P=0.021) and OS (P=0.007) rates than those treated with Protocol B.

ConclusionsApplication of As2O3 and ATRA as induction and consolidation chemotherapy resulted in excellent outcomes and improved long-term prognosis in children with newly diagnosed APL.

语种: 英语
WOS记录号: WOS:000330101800002
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/63043
Appears in Collections:北京大学第二临床医学院_儿科_期刊论文

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作者单位: Peking Univ, Affiliated Peoples Hosp, Dept Paediat, Sch Med, Beijing 100044, Peoples R China

Recommended Citation:
Cheng, Yifei,Zhang, Leping,Wu, Jun,et al. Long-term prognosis of childhood acute promyelocytic leukaemia with arsenic trioxide administration in induction and consolidation chemotherapy phases: a single-centre experience[J]. EUROPEAN JOURNAL OF HAEMATOLOGY,2013,91(6):483-489.
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