Clinicopathologic features and outcome of 12 consecutive patients with relapsed-acute promyelocytic leukemia treated with oral As2O3
. | . | . | . | . | Relapse . | . | . | Oral As2O3 therapy . | . | . | . | . | . | . | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patient no. . | Sex/age, y . | Status . | Previous induction treatment . | Time from last CR, mo . | Hb, g/L . | WBC, × 109/L . | Plat, × 109/L . | Duration, d . | Additional Rx . | Result . | Consolidation . | Latest PCR† (mo) . | DFS, mo . | Remarks . | ||||
| 1* | M/23 | R1 | ATRA + Dauno | 11 | 156 | 2.1 | 87 | 59 | Ida | CR | Ida | 13 | — | |||||
| R2 | IV As2O3 + Ida | 10 | 140 | 2.5 | 25 | 76 | ATRA | NR | — | + (dead) | — | |||||||
| 2* | M/33 | R2 | Dauno/IV As2O3 + Ida | 25 | 134 | 2.1 | 20 | 32 | ATRA | CR | As2O3 + ATRA | − (18) | 19+ | — | ||||
| 3* | F/13 | R2 | ATRA + IV As2O3 | 12 | 86 | 1.2 | 15 | 30 | ATRA | CR | As2O3 + ATRA | − (18) | 19+ | — | ||||
| 4 | M/54 | R1 | ATRA + Dauno | 100 | 85 | 34.8 | 81 | 40 | Ida | CR | Ida | − (18) | 18+ | Mother:AML | ||||
| 5* | M/32 | R1 | ATRA + Dauno + MP | 22 | 145 | 2.4 | 177 | 33 | NA | CR | Ida | − (18) | 18+ | — | ||||
| 6 | F/32 | R1 | ATRA + Dauno | 12 | 122 | 0.8 | 84 | 51 | NA | CR | Ida | − (12) | 18+ | — | ||||
| 7* | F/45 | R2 | ATRA + Dauno/IV As2O3 + Ida | 17 | 112 | 1.9 | 50 | 37 | ATRA | CR | As2O3 + ATRA | − (14) | 17+ | — | ||||
| 8 | F/65 | R1 | ATRA | 16 | 72 | 2.8 | 141 | 28 | NA | CR | As2O3 + ATRA | − (12) | 15+ | CRF due to DM on CAPD, Ida consolidation omitted due to CRF | ||||
| 9 | F/18 | R2 | ATRA + Dauno/IV As2O3 + Ida | 12 | 101 | 1.9 | 180 | 28 | ATRA | CR | As2O3 + ATRA | − (12) | 14+ | — | ||||
| 10* | F/18 | R1 | ATRA + Dauno | 12 | 82 | 12.6 | 54 | 44 | Ida | CR | Ida | − (6) | 9+ | — | ||||
| 11* | M/45 | R1 | ATRA + Dauno | 240 | 42 | 0.6 | 9 | 22 | NA | CR | As2O3 | − (3) | 7+ | Ida consolidation omitted due to high cumulative doses of anthracycline | ||||
| 12 | F/40 | R1 | ATRA + Ara-c | 23 | 85 | 6.5 | 39 | 28 | Ida | CR | Ida | − (3) | 6+ | CRHD, double valve rep | ||||
. | . | . | . | . | Relapse . | . | . | Oral As2O3 therapy . | . | . | . | . | . | . | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patient no. . | Sex/age, y . | Status . | Previous induction treatment . | Time from last CR, mo . | Hb, g/L . | WBC, × 109/L . | Plat, × 109/L . | Duration, d . | Additional Rx . | Result . | Consolidation . | Latest PCR† (mo) . | DFS, mo . | Remarks . | ||||
| 1* | M/23 | R1 | ATRA + Dauno | 11 | 156 | 2.1 | 87 | 59 | Ida | CR | Ida | 13 | — | |||||
| R2 | IV As2O3 + Ida | 10 | 140 | 2.5 | 25 | 76 | ATRA | NR | — | + (dead) | — | |||||||
| 2* | M/33 | R2 | Dauno/IV As2O3 + Ida | 25 | 134 | 2.1 | 20 | 32 | ATRA | CR | As2O3 + ATRA | − (18) | 19+ | — | ||||
| 3* | F/13 | R2 | ATRA + IV As2O3 | 12 | 86 | 1.2 | 15 | 30 | ATRA | CR | As2O3 + ATRA | − (18) | 19+ | — | ||||
| 4 | M/54 | R1 | ATRA + Dauno | 100 | 85 | 34.8 | 81 | 40 | Ida | CR | Ida | − (18) | 18+ | Mother:AML | ||||
| 5* | M/32 | R1 | ATRA + Dauno + MP | 22 | 145 | 2.4 | 177 | 33 | NA | CR | Ida | − (18) | 18+ | — | ||||
| 6 | F/32 | R1 | ATRA + Dauno | 12 | 122 | 0.8 | 84 | 51 | NA | CR | Ida | − (12) | 18+ | — | ||||
| 7* | F/45 | R2 | ATRA + Dauno/IV As2O3 + Ida | 17 | 112 | 1.9 | 50 | 37 | ATRA | CR | As2O3 + ATRA | − (14) | 17+ | — | ||||
| 8 | F/65 | R1 | ATRA | 16 | 72 | 2.8 | 141 | 28 | NA | CR | As2O3 + ATRA | − (12) | 15+ | CRF due to DM on CAPD, Ida consolidation omitted due to CRF | ||||
| 9 | F/18 | R2 | ATRA + Dauno/IV As2O3 + Ida | 12 | 101 | 1.9 | 180 | 28 | ATRA | CR | As2O3 + ATRA | − (12) | 14+ | — | ||||
| 10* | F/18 | R1 | ATRA + Dauno | 12 | 82 | 12.6 | 54 | 44 | Ida | CR | Ida | − (6) | 9+ | — | ||||
| 11* | M/45 | R1 | ATRA + Dauno | 240 | 42 | 0.6 | 9 | 22 | NA | CR | As2O3 | − (3) | 7+ | Ida consolidation omitted due to high cumulative doses of anthracycline | ||||
| 12 | F/40 | R1 | ATRA + Ara-c | 23 | 85 | 6.5 | 39 | 28 | Ida | CR | Ida | − (3) | 6+ | CRHD, double valve rep | ||||
DFS indicates disease-free survival; M, male; R1, first relapse; ATRA, all-trans retinoic acid; Dauno, daunorubicin; Ida, idarubicin; CR, complete remission; —, none; IV, intravenous; R2, second relapse; NR, nonremission; F, female; AML; acute myeloid leukemia; NA, no additional Rx; CRF, chronic renal failure; DM, diabetes mellitus; CAPD, continuous ambulatory peritoneal dialysis; Ara-c, cytosine arabinoside; CRHD, chronic rheumatic heart disease; and rep, replacement.
Pharmacokinetic data of oral As2O3 have previously been reported.4
PCR for PML/RARA. + indicates positive; −, negative, (time from initial diagnosis).