Arsenic Beats Chemo in Acute Promyelocytic Leukemia

According to a presentation at the most recent annual meeting of the American Society of Hematology in Atlanta, a treatment regimen for certain patients with acute promyelocytic leukemia (APL) significantly outperformed standard chemotherapy.

Patients with APL who were considered low-risk experienced a two-year event-free, disease-free and overall survival rate that approached 100 percent when treated with a combination of arsenic trioxide (ATO) and all-trans-retinoic acid (ATRA), compared to those patients who received ATRA plus idarubicin followed by anthracycline-based maintenance and consolidation therapy.

More specifically, all 75 patients treated with the ATO-ATRA regimen achieved a complete response and recurrence rates were just 1.6 percent, whereas 75 of the 79 patients treated with the chemotherapy regimen achieved complete response and recurrence rates were 4.3 percent.

A treatment regimen that is chemotherapy-free and does not include an anthracycline ought to bode well for patients down the road and cut down on the possibility of developing a secondary leukemia from a primary cancer treatment that included chemotherapy.

Said ASH press conference moderator William G. Woods, MD, of Children's Healthcare of Atlanta:

"This is the first curative treatment for acute promyelocytic leukemia that does not include myelosuppressive chemotherapy. This is a huge step toward front-line use of targeted drugs for acute leukemia."

It should be noted that this was a so-called "non-inferiority study" because the standard treatment for APL is highly regarded and has helped to turn a once-fatal disease into a very curable one.

Source: MedPage Today