April 15, 2014
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Consolidation with arsenic trioxide averted maintenance therapy in APL

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Treatment with arsenic trioxide during consolidation may obviate the need for maintenance therapy in patients with previously untreated low- and intermediate-risk acute promyelocytic leukemia, according to study results.

In a noninferiority trial, researchers evaluated 105 patients aged 18 years or older with recently diagnosed low- or intermediate-risk acute promyelocytic leukemia (APL). The patients underwent a first-line treatment regimen consisting of a standard induction, and a consolidation regimen that included arsenic trioxide (ATO).

Post-consolidation, 68 patients who were negative for PML-RARA translocation via polymerase chain reaction were randomly assigned to 1 year of maintenance with tretinoin, mercaptopurine and methotrexate, or observation. Enrollment in the study was discontinued early due to slow amassing of participants.

At a median follow-up of 36.1 months, the OS rate for all 105 patients was 93%. Researchers reported no relapses in patients randomly assigned to maintenance treatment or observation.

The findings suggest that consolidation treatment with ATO may be useful in maintaining long-term curative benefits in patients with low- and intermediate-risk APL, according to researchers.

“These results demonstrate that cures can be expected in more than 90% of patients with low- and intermediate-risk APL, and suggest that maintenance therapy may not be needed if patients are treated with an intensive post-remission regimen including ATO,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.