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Real‑world data on the dose‑related effect of arsenic trioxide in the relapse of acute promyelocytic leukemia

  • Authors:
    • Sha Gong
    • Huaiyu Wang
    • Huiyun Zhang
    • Wei Liu
    • Xinxin Zhang
    • Chenyang Zhao

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  • Published online on: October 26, 2020     https://doi.org/10.3892/mco.2020.2161
  • Article Number: 91
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Abstract

Acute promyelocytic leukemia (APL) has become a highly curable disease with all‑trans retinoic acid‑based regimens. However, following the administration of arsenic trioxide (ATO), the relapse rate remains at 1‑10%. It is not known whether the dosage of ATO is associated with the relapse rate in real‑world settings. According to 2019 National Comprehensive Cancer Network guidelines, the recommended cumulative ATO dosage in post‑remission therapy is 7.95‑12 mg/kg in APL. In the current study, 112 patients with newly diagnosed APL receiving a combination of all‑trans retinoic acid, anthracycline‑based chemotherapy and different dosages of ATO for variable courses, were divided into the high‑dose (ATO dosage, ≥12 mg/kg) and low‑dose groups (ATO dosage, <12 mg/kg). Relapse risk factors were analyzed by multiple factor analysis. The relationship between relapse rate and ATO dosage in post‑remission was elucidated by determining the 4‑year cumulative incidence of relapse (CIR). Based on the ATO dosage in post‑remission therapy, 72 (64.3%) patients were in the low‑dose group and 40 (35.7%) were in the high‑dose group. An increased ATO dosage was demonstrated to be an independent protective factor in terms of probability of relapse (P=0.004). With a median follow‑up time of 53 months, the 4‑year CIR was 16.7% in the low‑dose group and 0% in the high‑dose group, respectively (P=0.008). No patient relapsed when administered an ATO dosage >6 mg/kg. In conclusion, the relapse rate of APL was significantly associated with ATO dosage in post‑remission therapy. An increased ATO dosage may serve as a protective factor of relapse. ATO dosage should therefore reach up to 12 mg/kg, with consideration to reduce the dosage in the future.
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December-2020
Volume 13 Issue 6

Print ISSN: 2049-9450
Online ISSN:2049-9469

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  • CiteScore: 2.8
  • CiteScore Rank: Q3: #250/404 Oncology
  • Source Normalized Impact per Paper (SNIP): 0.55
  • SCImago Journal Rank (SJR): 0.446
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Spandidos Publications style
Gong S, Wang H, Zhang H, Liu W, Zhang X and Zhao C: Real‑world data on the dose‑related effect of arsenic trioxide in the relapse of acute promyelocytic leukemia. Mol Clin Oncol 13: 91, 2020.
APA
Gong, S., Wang, H., Zhang, H., Liu, W., Zhang, X., & Zhao, C. (2020). Real‑world data on the dose‑related effect of arsenic trioxide in the relapse of acute promyelocytic leukemia. Molecular and Clinical Oncology, 13, 91. https://doi.org/10.3892/mco.2020.2161
MLA
Gong, S., Wang, H., Zhang, H., Liu, W., Zhang, X., Zhao, C."Real‑world data on the dose‑related effect of arsenic trioxide in the relapse of acute promyelocytic leukemia". Molecular and Clinical Oncology 13.6 (2020): 91.
Chicago
Gong, S., Wang, H., Zhang, H., Liu, W., Zhang, X., Zhao, C."Real‑world data on the dose‑related effect of arsenic trioxide in the relapse of acute promyelocytic leukemia". Molecular and Clinical Oncology 13, no. 6 (2020): 91. https://doi.org/10.3892/mco.2020.2161