급성전골수성백혈병에서 All-trans retinoic acid 또는 Arsenic trioxide를 사용한 치료 결과
Salvage treatments with all-trans retinoic acid and arsenic trioxide-based regimens in acute promyelocytic leukemia
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Background/Aims : Acute promyelocytic leukemia is a distinct subtype of acute myeloid leukemia with a specific clinical and molecular presentation. Treatment of acute promyelocytic leukemia with all-trans retinoic acid or arsenic trioxide in association with anthracyclin has improved outcomes in this disease. We report the results of all-trans retinoic acid and arsenic trioxide-based treatment regimens in acute promyelocytic leukemia patients diagnosed in a single center. Methods : Thirty-seven treatment events in 26 patients with acute promyelocytic leukemia were retrospectively reviewed. Results : Complete remission was achieved in 29 (78.4%) of 37 treatment events. One-year overall survival rate and 1-year event-free survival rate were 74.3% and 66.3%, respectively. Among 16 patients treated with an arsenic trioxide-based regimen, 14 patients (87.5%) achieved complete remission. The 1-year overall survival rate and 1-year event-free survival rate were 78.4% and 69.6%, respectively. Conclusions : The short-term use of arsenic trioxide for salvage treatment of acute promyelocytic leukemia seems to be efficacious and could be a bridge to intensive chemotherapy or stem cell transplantation in terms of minimizing the risk of severe disseminated intravascular coagulation. (Korean J Med 74:596-604, 2008)
Abstract
Background/Aims : Acute promyelocytic leukemia is a distinct subtype of acute myeloid leukemia with a specific clinical and molecular presentation. Treatment of acute promyelocytic leukemia with all-trans retinoic acid or arsenic trioxide in association with anthracyclin has improved outcomes in this disease. We report the results of all-trans retinoic acid and arsenic trioxide-based treatment regimens in acute promyelocytic leukemia patients diagnosed in a single center. Methods : Thirty-seven treatment events in 26 patients with acute promyelocytic leukemia were retrospectively reviewed. Results : Complete remission was achieved in 29 (78.4%) of 37 treatment events. One-year overall survival rate and 1-year event-free survival rate were 74.3% and 66.3%, respectively. Among 16 patients treated with an arsenic trioxide-based regimen, 14 patients (87.5%) achieved complete remission. The 1-year overall survival rate and 1-year event-free survival rate were 78.4% and 69.6%, respectively. Conclusions : The short-term use of arsenic trioxide for salvage treatment of acute promyelocytic leukemia seems to be efficacious and could be a bridge to intensive chemotherapy or stem cell transplantation in terms of minimizing the risk of severe disseminated intravascular coagulation. (Korean J Med 74:596-604, 2008)
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