PS1047 EFFICACY AND SAFETY EVALUATION OF DIFFERENT DOSES OF ANTHRACYCLINES IN THE INDUCTION THERAPY FOR NEWLY DIAGNOSED ACUTE PROMYELOCYTIC LEUKEMIA

Abstract

Background:Acute promyelocytic leukemia (APL) is a kind of specific acute myeloid leukemia (AML) subtype characterized by abnormal coagulation function and high cure rate. More than 95% of the cases were characterized by balanced translocations of the PML gene on chromosome 15 and the RARα gene on chromosome 17.Currently, induction therapies for acute promyelocytic leukemia (APL) are mainly a combination of anthracyclines, ATRA and arsenic, which can not only prolong the long‐term survival of patients with APL and significantly reduce the recurrence rate, but also control differentiation syndrome (DS) by adding chemotherapy drugs.However,chemotherapy with anthracyclines inevitably leads to bone marrow suppression, which increases the risk of infection and bleeding.This study was conducted to explore the appropriate dose of anthracyclines in the induction therapy of newly diagnosed APL, so as to reduce bone marrow suppression and thus reduce the risk of infection and bleeding.Aims:To investigate the efficacy and safety of induction regimens containing arsenite, total trans‐retinoic acid (ATRA) and anthracyclines in different doses as induction chemotherapy for acute promyelocytic leukemia (APL).Methods:From January 2011 to December 2017, 129 consecutive hospitalized newly diagnosed APL patients were retrospectively analyzed.Of them,66 patients received arsenite, ATRA and anthracyclines in low doses as induction chemotherapy(low dose group).While another 63 patients received arsenite, ATRA and anthracyclines in standard doses as induction chemotherapy(standard dose group).Results:There were no statistically significant differences in terms of age, gender, routine blood indexes,LDH,bone marrow promyelocyte count,prognostic stratification of onset between the two groups (P > 0.05).During the treatment, there were no significant differences between the two groups in WBC count peak and the time point when the value appeared (P > 0.05). Both induction regimens showed good efficacy.The gene conversion rate of PML‐RARα,the 2‐year over all survival and disease free survival in the low‐dose group were similar to those in the standard dose group(P>0.05).There was no statistical difference in the gene conversion rate of PML‐RARα between the low dose group and the standard dose group (P = 0.078). The recovery time of neutrophils and platelets in the low‐dose group were 0 d and 11 d, respectively, which were lower than the standard dose group (3 d,15 d) with statistically difference (both P = 0.000). The median amount of platelet and erythrocyte transfusion in the low dose group were 6.9 U and 4.2 U, respectively, which were lower than the standard dose group (8.4U,6.8U) with statistically difference (P = 0.037, 0.000). And the inpatient days in the low dose group and the standard dose group was 30.98 d and 30.71 d, respectively (P = 0.770).Summary/Conclusion:For patients newly diagnosed with APL,there was indiscrimination of efficacy between induction therapy containing arsenite,ATRA and low dose anthracyclines with the therapy containing arsenite,ATRA and standard dose anthracyclines,and the former regimen appears even safer.