Evaluation of the efficacy of maintenance therapy for low-to-intermediate-risk acute promyelocytic leukemia in molecular remission: A retrospective single-institution study

Yamamoto,Masahide; Okada,Keigo; Akiyama,Hiroki; Kurosu,Tetsuya; Miura,Osamu

doi:10.3892/mco.2014.476

March-2015 Volume 3 Issue 2

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March-2015 Volume 3 Issue 2

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Article

Evaluation of the efficacy of maintenance therapy for low-to-intermediate-risk acute promyelocytic leukemia in molecular remission: A retrospective single-institution study

Authors:
- Masahide Yamamoto
- Keigo Okada
- Hiroki Akiyama
- Tetsuya Kurosu
- Osamu Miura
View Affiliations / Copyright

Affiliations: Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113‑8519, Japan
Pages: 449-453
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Published online on: December 10, 2014

https://doi.org/10.3892/mco.2014.476
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Abstract

The prognosis of acute promyelocytic leukemia (APL) has become the most favorable among all acute myeloid leukemias, due to the efficacy of treatment with all‑trans retinoic acid (ATRA). ATRA combined with anthracycline‑based chemotherapy has significantly improved the long‑term outcome for low‑to‑intermediate‑risk APL patients; thus, the efficacy of maintenance therapy for patients achieving molecular complete remission (MCR) following consolidation therapy has become debatable. To evaluate the efficacy of maintenance therapy, we conducted a retrospective analysis of 11 consecutive patients with low‑to‑intermediate‑risk APL who received induction and consolidation therapy with ATRA and anthracyclines according to the PETHEMA LPA protocols at our hospital between January, 2001 and March, 2013. All the patients achieved MCR following consolidation therapy. Of these patients, 7 were followed without maintenance therapy, including 2 patients who discontinued maintenance therapy within 2 months. With a median follow‑up of 85 months, the overall survival for all the patients was 100%, while the disease‑free survival estimate at 5 years with and without maintenance therapy was 100 and 85.7%, respectively; the difference was not statistically significant (P=0.45). Two patients treated with maintenance therapy later developed secondary primary malignancy. Thus, even without maintenance therapy, ATRA combined with anthracyclines exhibited significant efficacy in low‑to‑intermediate‑risk APL patients, suggesting that maintenance therapy, which is associated with adverse events, may be dispensable for patients achieving MCR following adequate consolidation therapy.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Evaluation of the efficacy of maintenance therapy for low-to-intermediate-risk acute promyelocytic leukemia in molecular remission: A retrospective single-institution study

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