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Blood, 1 May 2006, Vol. 107, No. 9, pp. 3469-3473. Prepublished online as a Blood First Edition Paper on December 22, 2005; DOI 10.1182/blood-2005-10-4006. This Article Full Text Full Text (PDF) All Versions of this Article: 2005-10-4006v1 107/9/3469    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Estey, E. Articles by Kantarjian, H. Search for Related Content PubMed PubMed Citation Articles by Estey, E. Articles by Kantarjian, H. Related Collections Neoplasia Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Use of all-trans retinoic acid plus arsenic trioxide as an alternative to chemotherapy in untreated acute promyelocytic leukemia Elihu Estey, Guillermo Garcia-Manero, Alessandra Ferrajoli, Stefan Faderl, Srdan Verstovsek, Dan Jones, and Hagop Kantarjian From the Departments of Leukemia and Hematopathology, University of Texas M.D. Anderson Cancer Center, Houston, TX. We examined whether combining all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) might be an alternative to ATRA plus chemotherapy in untreated acute promyelocytic leukemia (APL). Twenty-five low-risk patients (white blood cell [WBC] count less than 10 x 109/L [10 000/µL]) received ATRA (45 mg/m2 daily) and ATO (0.15 mg/kg daily, beginning day 10 of ATRA), and in complete remission (CR) received ATO plus ATRA, without chemotherapy, unless they were reverse transcriptase–polymerase chain reaction (RT-PCR)–positive 3 months from CR date or had molecular relapse. Nineteen high-risk patients were treated identically, but received chemotherapy, generally 9 mg/m2 gemtuzumab ozogamycin (GO) on day 1 of induction. The CR rate was 39 of 44 (24 of 25 in low-risk, 15 of 19 in high-risk). Disease recurred at 9, 9, and 15 months, respectively, in 3 high-risk patients. The median follow-up time from CR date in the 36 patients alive in first CR is 16 months (15 months in low-risk, 20 months in high-risk), with 9 patients followed for at least 24 months. Each of the 36 patients was PCR-negative at last follow-up. Thus, none of the low-risk patients has received chemotherapy, and only 3 high-risk patients (the 3 with relapsed disease) have received chemotherapy past induction. ATRA plus ATO may serve as an alternative to chemotherapy in low-risk untreated APL (eg, in older patients) and, when combined with GO, may improve outcome in high-risk patients. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: From rags to riches Martin S. Tallman Blood 2006 107: 3425. [Full Text] [PDF] This article has been cited by other articles: L. Leu and L. Mohassel Arsenic trioxide as first-line treatment for acute promyelocytic leukemia Am. J. Health Syst. Pharm., November 1, 2009; 66(21): 1913 - 1918. [Abstract] [Full Text] [PDF] R. Nasr, V. Lallemand-Breitenbach, J. Zhu, M.-C. Guillemin, and H. de The Therapy-induced PML/RARA Proteolysis and Acute Promyelocytic Leukemia Cure Clin. Cancer Res., October 15, 2009; 15(20): 6321 - 6326. 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