NEW YORK (Reuters Health) Feb 16 - A new report confirms the long-term safety and efficacy of all-trans retinoic acid (ATRA)/arsenic trioxide (ATO) combination therapy in patients with newly diagnosed acute promyelocytic leukemia.
The safety and efficacy of ATRA/ATO had been shown in short-term studies, Dr. Zhu Chen and colleagues explain in the February 16th Early Edition of the Proceedings of the National Academy of Sciences, but long-term data were lacking.
In the current report, Dr. Chen, from the Shanghai Institute of Hematology, China, and colleagues discuss the outcomes of 85 patients who were followed for a median of 70 months.
Complete remission was achieved in 94.1% of patients, the report indicates.
Overall and event-free survival at 5 years were 91.7% and 89.2%, respectively. Among complete responders, the 5-year relapse-free and overall survival rates were 94.8% and 97.4%, respectively.
Initial white blood cell count, distinct PML-RAR-alpha types, or FLT3 mutations had no bearing on prognosis in the study group.
In general, ATRA/ATO therapy was well tolerated and side effects were mild and reversible. No secondary malignancies were seen, and 2 years after the final dose of therapy, urine arsenic levels were well below toxic levels.
"The ATRA/ATO-based treatment regimen incorporating chemotherapy for both remission induction and postremission therapy for newly diagnosed acute promyelocytic leukemia yields an encouraging long-term survival rate greater than 90% with alleviated side effects, and thus reinforces its potential use as a frontline therapy for de novo acute promyelocytic leukemia," the authors conclude.
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