Therapeutic effects of arsenic trioxide plus all-trans retinoic acid on acute promyelocytic leukemia

Objective: The aim of the current study was to observe the therapeutic effects of arsenic trioxide (ATO) plus all-trans retinoic acid (ATRA) on acute promyelocytic leukemia. Methods: A total of 92 patients with acute promyelocytic leukemia were selected and assigned into the control group (44 patients that received ATRA) and observation group (48 patients that received ATRA plus ATO). Patients were observed for the required treatment time to achieve complete remission during induction chemotherapy. They were detected for negative conversation of the PML-RARa gene after treatment using gene detection. Total amount of platelet and plasma transfusion during chemotherapy, incidence of adverse reactions after chemotherapy, overall survival (OS), and disease-free survival (DFS) were recorded. Results: The time required for first complete remission in the observation group was shorter than that in the control group. The negative conversion rate of the PML-RARa gene was higher in the observation group than in the control group. The volume of plasma and platelet transfusion in the observation group was less than that of the control group, with statistical differences (all P < 0.05). Cases of complete remission, as well as 5-year OS and DFS, were significantly less in patients with high white blood cell counts and/or low platelet counts, detected at initial diagnosis, than in patients with lower white blood cell counts and/or low platelet counts at initial diagnosis. There were no differences in OS between the two groups within 5 years (P > 0.05), but the DFS of the observation group was longer than that of the control group, with statistical differences (P < 0.05). Conclusion: ATRA plus ATO for treatment of acute promyelocytic leukemia can shorten remission times, increase the negative conversion rate of the PML-RARa gene, and improve the DFS of patients. Moreover, high white blood cell counts, along with low platelet counts, were shown to be important markers of poor prognosis.