Curing Acute Promyelocytic Leukemia Without Chemotherapy

Researchers are reporting on a treatment regimen for acute promyelocytic leukemia (APL) that appears to be as effective as standard chemotherapy – without using chemotherapy.

According to Francesco Lo-Coco, MD, of the University Tor Vergata in Rome, and colleagues, reporting online in the New England Journal of Medicine, a regimen using all-trans retinoic acid (ATRA) plus arsenic trioxide brought about a higher complete remission rate in a phase III trial at a median follow up of 34.4 months than the current standard of care, which is ATRA plus anthracycline-based chemotherapy.

In the study, all 77 patients randomized to ATRA plus arsenic trioxide achieved complete remission, compared to 75 of 79 patients receiving the standard of care.

Acute promyelocytic leukemia is a highly treatable and often curable subtype of leukemia. Remission rates hover around 90 percent and cure rates around 80 percent, but the current standard of care leaves a bit to be desired in terms of the hematologic toxicity.

That's where ATRA plus arsenic trioxide appears to become more appealing, since it is a less toxic alternative in that regard.

The only drawback was that the new regimen appeared to cause more issues with hepatic toxicity.

The investigators believe these findings warrant more research into this regimen.

Source: NEJM