Arsenic Trioxide in Untreated APL

Abstract

For many years, the combination of all-trans retinoic acid (ATRA) and an anthracycline (daunorubicin or idarubicin) constituted standard treatment for acute promyelocytic leukemia (APL). More recently, arsenic trioxide (ATO) has been found to be a more effective anti-APL drug than ATRA; used alone ATO produces cures in newly diagnosed APL much more frequently than ATRA. This observation has prompted use of the combination of ATO and ATRA in newly diagnosed APL. Although follow-up time with this treatment is much less than with the more standard treatment, results of a randomized trial suggest that ATO plus ATRA produces superior 2-year event-free survival than does ATRA plus anthracycline.