TY - JOUR
T1 - All-trans retinoic acid therapy in relapsed/refractory or newly diagnosed acute promyelocytic leukemia (APL) in Japan
AU - Ohno, Ryuzo
AU - Ohnishi, Kazunori
AU - Takeshita, Akihiro
AU - Tanimoto, Mitsune
AU - Murakami, Hirokazu
AU - Kanamaru, Akihisa
AU - Asou, Norio
AU - Kobayashi, Tohru
AU - Kuriyama, Kazutaka
AU - Ohmoto, Eijiro
AU - Sakamaki, Hisashi
AU - Tsubaki, Kazuo
AU - Hiraoka, Akira
AU - Yamada, Osamu
AU - Oh, Hakumei
AU - Furusawa, Shinpei
AU - Matsuda, Shin
AU - Naoe, Tomoki
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 1994
Y1 - 1994
N2 - 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.
AB - 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.
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M3 - Article
C2 - 7808028
AN - SCOPUS:0028568378
VL - 8
SP - S64-S69
JO - Leukemia
JF - Leukemia
SN - 0887-6924
IS - SUPPL. 3
ER -