De-Escalating Therapy in Pediatric Acute Promyelocytic Leukemia

Remission and survival rates of nearly 100% were achieved with combined all-trans retinoic acid and arsenic-based induction therapy.

High cure rates are achieved in adults with acute promyelocytic leukemia (APML) using combined all-trans retinoic acid (ATRA) and arsenic trioxide, with or without anthracycline chemotherapy. Now, the Children's Oncology Group reports a multinational noninferiority trial of de-escalated induction therapy with ATRA plus arsenic trioxide in patients with APML aged 1 to 21. Standard-risk patients (white blood cell count <10,000/μL) received ATRA plus arsenic trioxide, and high-risk patients (WBC ≥10,000/μL) received the same treatment plus four doses of idarubicin. Following induction, all patients received four cycles of consolidation therapy with ATRA plus arsenic trioxide; no maintenance therapy was given.

During a median follow-up of 2 year…

Reviewing Author

Michael E. Williams, MD, ScM

Disclosures

Consultant/Advisory BoardAbbVie; AstraZeneca; Beigene; Janssen; Pharmacyclics

Grant/Research SupportJanssen

Editorial BoardsAmerican Board of Internal Medicine (ABIM) Hematology Longitudinal Knowledge Approval Committee

Michael E. Williams, MD, ScM

Disclosures

Consultant/Advisory BoardAbbVie; AstraZeneca; Beigene; Janssen; Pharmacyclics

Grant/Research SupportJanssen

Editorial BoardsAmerican Board of Internal Medicine (ABIM) Hematology Longitudinal Knowledge Approval Committee

De-Escalating Therapy in Pediatric Acute Promyelocytic Leukemia

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Reviewing Author