Long-term follow-up of homoharringtonine plus all-trans retinoic acid-based induction and consolidation therapy in newly diagnosed acute promyelocytic leukemia

• Published in: International journal of hematology Vol. 101; no. 3; pp. 279 - 285
• Main Authors: Wang, Ying, Lin, Dong, Wei, Hui, Li, Wei, Liu, Bingcheng, Zhou, Chunlin, Liu, Kaiqi, Mi, Yingchang, Wang, Jianxiang
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.03.2015; Springer Nature B.V
• Subjects: Adolescent; Adult; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Antineoplastic Agents - toxicity; Body Mass Index; Consolidation Chemotherapy; Disease-Free Survival; Female; Follow-Up Studies; Harringtonines - adverse effects; Harringtonines - therapeutic use; Harringtonines - toxicity; Hematology; Humans; Induction Chemotherapy; Leukemia, Promyelocytic, Acute - diagnosis; Leukemia, Promyelocytic, Acute - drug therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Retrospective Studies; Tretinoin - adverse effects; Tretinoin - therapeutic use; Tretinoin - toxicity; Young Adult; Body mass index; Acute promyelocytic leukemia; Homoharringtonine; Overall survival; Follow-up
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-014-1730-8

We conducted a retrospective study to evaluate the efficacy of combining homoharringtonine (HHT) with all-trans-retinoic acid (ATRA)-based induction therapy, followed by three courses of consolidation chemotherapy and 2-year sequential maintenance therapy in acute promyelocytic leukemia (APL). Fifty-three patients were enrolled in the study. The complete remission (CR) rate was 100 %. No patient died during induction therapy. The 9-year event-free survival (EFS) and 9-year overall survival (OS) for all patients were 79.0 and 83.0 %, respectively. Outcome estimates according to the body mass index (BMI) were carried out. Twenty-three (43.4 %) were underweight/normal (BMI < 23.0 kg/m 2 ), whereas 30 patients (56.6 %) were overweight/obese (BMI ≥ 23.0 kg/m 2 ). Underweight/normal-weight patients had a 9-year OS of 100 %, compared with 73.0 % for overweight/obese patients ( P  = 0.044). These results indicate that HHT plus ATRA-based induction and consolidation therapy may be a highly efficacious treatment option for newly diagnosed APL. Increased BMI had an adverse prognostic impact in APL.