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2013, Number 3

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Gac Med Mex 2013; 149 (3)

Low-dose all- retinoic acid in adults with acute promyelocytic leukemia

Ramos-Blas G, López-Karpovitch X, Crespo-Solís E, Aguayo Á

Language: Spanish
References: 39
Page: 265-271
PDF size: 94.80 Kb.


ABSTRACT

Background: Standard therapy in patients with acute promyelocytic leukemia (APL) includes all-trans retinoic acid (ATRA) (45 mg/m2) and chemotherapy. A previous study showed that therapeutic efficacy between low-dose ATRA (25 mg/m2) and standard dose of ATRA was alike. Objective: To evaluate complete remission (CR) and survival (SV) in untreated adults with APL exposed to low-dose ATRA and daunorubicin (DNR). Material and method: Patients diagnosed between 2000-2006 were included. Induction therapy (IT) consisted of ATRA (25 mg/m2) and DNR (45 mg/m2), followed by three consolidations with ATRA (25 mg/m2) and DNR (25 mg/m2). Maintenance included 6-mercaptopurine, methotrexate and ATRA (25 mg/m2) for two years. Results: Median age of the 19 patients was 31 years. CR was achieved by 78.9% of patients. Mortality during IT was 15.8%. Forty percent of patients relapsed and all achieved second CR with ATRA (45 mg/m2) and chemotherapy. With a median follow-up of 2.97 years for the entire group SV was 57.9%. Conclusion: Although CR rate with low-dose ATRA is acceptable, doses of ATRA ‹ 45 mg/m2 for in untreated adults with APL are not recommend due to its high relapse rate.


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