Ghavamzadeh A, Alimoghaddam K, Ghaffari S H, Rostami S, Jahani M, Hosseini R, Mossavi A, Baybordi E, Khodabadeh A, Iravani M, Bahar B, Mortazavi Y, Totonchi M, Aghdami N
Haematology, Oncology and BMT Research Centre, Tehran University of Medical Sciences, Tehran, Iran.
Ann Oncol. 2006 Jan;17(1):131-4. doi: 10.1093/annonc/mdj019. Epub 2005 Oct 14.
Arsenic trioxide is effective and approved for treatment of relapsed or refractory acute promyelocytic leukemia (APL) cases resistant to all-trans retinoic acid (ATRA), but its effect on new cases of APL is not clear.
We studied 111 patients with APL. Arsenic trioxide was infused at 0.15 mg/kg daily dose, until complete remission was achieved. Then, after 28 days of rest, arsenic trioxide was infused daily for 28 days as consolidation therapy. We studied minimal residual disease (MRD) by semi-sensitive reverse transcription polymerase chain reaction (RT-PCR) on peripheral blood samples.
Complete remission was observed in 95 patients (85.6%). With the median (range) follow-up period of 16.5 (1-57) months, 1- and 2-year disease-free survival was 88.3% and 63.7%, respectively; 24 patients relapsed, 19 of whom achieved a second complete remission, again by arsenic trioxide. Third and fourth remissions were seen in some relapsed patients, again by arsenic trioxide. For patients in complete remission, 1- and 3-year survival was 95.5% and 87.6%, respectively. MRD was positive in four (8.3%) out of 48 cases during 1 year after remission induction; three of them relapsed clinically.
Arsenic trioxide is effective as first-line treatment for APL. Results of arsenic trioxide combination therapy with chemotherapy/ATRA requires further study.
三氧化二砷对复发或难治性、对全反式维甲酸（ATRA）耐药的急性早幼粒细胞白血病（APL）病例有效且已获批准，但它对APL新发病例的疗效尚不清楚。
我们研究了111例APL患者。三氧化二砷以每日0.15mg/kg的剂量静脉输注，直至达到完全缓解。然后，休息28天后，三氧化二砷每日输注28天作为巩固治疗。我们通过半敏感逆转录聚合酶链反应（RT-PCR）对外周血样本进行微小残留病（MRD）研究。
95例患者（85.6%）观察到完全缓解。中位（范围）随访期为16.5（1 - 57）个月，1年和2年无病生存率分别为88.3%和63.7%；24例患者复发，其中19例再次通过三氧化二砷达到第二次完全缓解。部分复发患者再次通过三氧化二砷实现了第三次和第四次缓解。对于完全缓解的患者，1年和3年生存率分别为95.5%和87.6%。缓解诱导后1年内，48例中有4例（8.3%）MRD呈阳性；其中3例临床复发。
三氧化二砷作为APL的一线治疗有效。三氧化二砷与化疗/ATRA联合治疗的结果需要进一步研究。
