All-trans retinoic acid therapy in relapsed/refractory or newly diagnosed acute promyelocytic leukemia (APL) in Japan

Ryuzo Ohno, Kazunori Ohnishi, Akihiro Takeshita, Mitsune Tanimoto, Hirokazu Murakami, Akihisa Kanamaru, Norio Asou, Tohru Kobayashi, Kazutaka Kuriyama, Eijiro Ohmoto, Hisashi Sakamaki, Kazuo Tsubaki, Akira Hiraoka, Osamu Yamada, Hakumei Oh, Shinpei Furusawa, Shin Matsuda, Tomoki Naoe

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

We have conducted four prospective multicenter studies for acute promyelocytic leukemia (APL) using oral 45 mg/m2 all-trans retinoic acid (ATRA) daily. The first three studies were for relapsed/refractory APL, and the fourth study for newly diagnosed APL. In the first study with ATRA alone, 18 (82%) of 22 evaluable patients achieved complete remission (CR). Initial peripheral leukemia cell counts were significantly less in the CR cases (p<0.01); <100/μl in 17 of 18 CR cases, and ≥200/μl in all failure cases. In the second study, if initial leukemia cell counts were more than 200/μl, chemotherapy with daunorubicin and behenoyl cytarabine was first given, and then ATRA was started. Of 42 evaluable patients, 36 (86%) achieved CR. In the third study, if initial leukemia cell counts were more than 200/μl, chemotherapy was concomitantly given with ATRA, and if during the ATRA therapy leukemia cell counts became more than 1000/μl, chemotherapy was added. Of 46 evaluable patients, 36 (78%) achieved CR. Patients achieving CR received standard consolidation and maintenance chemotherapy, and the 29-month predicted disease-free survival (DFS) rate is 72% far 41 cases achieving their first CR with ATRA, and 20% for 49 cases achieving their second CR with ATRA. In the fourth study for newly diagnosed APL, if leukocyte counts were more than 3000/μl, chemotherapy was concomitantly given with ATRA, and if during the ATRA therapy leukemia cell counts became more than 1000/μl, chemotherapy was added. Of 109 evaluable patients, 97 (89%) achieved CR, and the 18-month predicted event-free survival rate for all patients is 78%, and the DFS rate is 88% for 97 cases achieving CR. ATRA produces a high CR rate in both relapsed/refractory and newly diagnosed APL, and should be incorporated in the first-line therapy of this disease.

Original languageEnglish
Pages (from-to)S64-S69
JournalLeukemia
Volume8
Issue numberSUPPL. 3
Publication statusPublished - 1994

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Fingerprint Dive into the research topics of 'All-trans retinoic acid therapy in relapsed/refractory or newly diagnosed acute promyelocytic leukemia (APL) in Japan'. Together they form a unique fingerprint.

  • Cite this

    Ohno, R., Ohnishi, K., Takeshita, A., Tanimoto, M., Murakami, H., Kanamaru, A., Asou, N., Kobayashi, T., Kuriyama, K., Ohmoto, E., Sakamaki, H., Tsubaki, K., Hiraoka, A., Yamada, O., Oh, H., Furusawa, S., Matsuda, S., & Naoe, T. (1994). All-trans retinoic acid therapy in relapsed/refractory or newly diagnosed acute promyelocytic leukemia (APL) in Japan. Leukemia, 8(SUPPL. 3), S64-S69.