Characteristics and outcome of patients with therapy-related acute promyelocytic leukemia front-line treated with or without arsenic trioxide
This study is a retrospective review on the outcomes of patients with therapy-related acute promyelocytic leukemia (APL). Therapy-related APL is rare, and this is a multi-institutional study.
Data on 103 adult patients who were treated between 1991-2015 were collected from 11 study groups and institutions in the US/ Europe. Cox proportional hazards regression model was used to identify prognostic variables for EFS, RFS, and OS.
The study showed difference in outcome based on the APL treatment. None of the patients treated with ATRA alone survived beyond one year. Event-free survival was significantly higher after ATO-based therapy (95%, 95% CI, 82-99%) as compared to CTX/ATRA (78%, 95% CI, 64-87%; P=0.042), if deaths due to recurrence of the prior malignancy were censored.
This was not a prospective study or RCT, therefore possible to have more confounding factors / biases. Further, this study only included adult patients, may not directly be applicable for pediatric oncology patients.