Retrospective analysis of 119 cases of pediatric acute promyelocytic leukemia: Comparisons of four treatment regimes

Li,En-Qin; Xu,Ling; Zhang,Zhi-Quan; Xiao,Yan; Guo,Hai-Xia; Luo,Xue-Qun; Hu,Qun; Lai,Dong-Bo; Tu,Li-Ming; Jin,Run-Ming

doi:10.3892/etm.2012.546

Retrospective analysis of 119 cases of pediatric acute promyelocytic leukemia: Comparisons of four treatment regimes

Authors:
- En-Qin Li
- Ling Xu
- Zhi-Quan Zhang
- Yan Xiao
- Hai-Xia Guo
- Xue-Qun Luo
- Qun Hu
- Dong-Bo Lai
- Li-Ming Tu
- Run-Ming Jin
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Affiliations: Department of Pediatrics, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China, Department of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong, P.R. China, Department of Pediatrics, Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P.R. China, Department of Pediatrics, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P.R. China, Department of Pediatrics, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China , Department of Pediatrics, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P.R. China
Published online on: April 17, 2012 https://doi.org/10.3892/etm.2012.546
Pages: 93-98

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Abstract

Clinical trials have demonstrated that pediatric acute promyelocytic leukemia (APL) is highly curable. Small-scale studies have reported on the treatment of APL using one or two treatment regimes. Here, we report a multiple center-based study of 119 cases of pediatric APL treated with four regimes based on all-trans-retinoic acid (ATRA). We retrospectively analyzed the clinical characteristics, laboratorial test results and treatment outcome of the pediatric APL patients. Regime 1 used an in-house developed protocol, regime 2 was modified from the PETHEMA LPA99 protocol, regime 3 was modified from the European-APL93 protocol, and regime 4 used a protocol suggested by the British Committee for Standards in Haematology. The overall complete remission rates for the four regimes were 88.9, 87.5, 97.1 and 87.5%, respectively, which exhibited no statistical difference. However, more favorable results were observed for regimes 2 and 3 than regimes 1 and 4, in terms of the estimated 3.5-year disease-free survivals, relapse rates, drug toxicity (including hepatotoxicity, cardiac arrhythmia, and differentiation syndrome) and sepsis. In conclusion, the overall outcomes were more favorable after treatment with regimes 2 and 3 than with regimes 1 and 4, and this may have been due to the specific compositions of regimes 2 and 3.

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