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Article: Arsenic trioxide in comparison with chemotherapy and bone marrow transplantation for the treatment of relapsed acute promyelocytic leukaemia

TitleArsenic trioxide in comparison with chemotherapy and bone marrow transplantation for the treatment of relapsed acute promyelocytic leukaemia
Authors
KeywordsAcute promyelocytic leukaemia
Allogeneic bone marrow transplantation
Arsenic trioxide
Relapse
Issue Date2003
PublisherOxford University Press. The Journal's web site is located at http://annonc.oxfordjournals.org/
Citation
Annals Of Oncology, 2003, v. 14 n. 5, p. 752-757 How to Cite?
AbstractBackground: The best overall treatment strategy for patients with acute promyelocytic leukaemia (APL) in relapse with chemotherapy, bone marrow transplantation (BMT) or arsenic trioxide (As 2O 3) based therapy remains undefined. Patients and methods: We reviewed the clinical course and treatment outcome of 143 APL cases seen in four major hospitals in Hong Kong over a 10-year period. Results: Complete remission (CR) was attained in 113 cases (79%) with all-trans retinoic acid (ATRA) and chemotherapy. Relapse occurred at a median of 16 months in 54 cases, with a 3-year disease free survival of 56%. Post-relapse treatment was successful in 41 cases (76%), giving an actuarial 3-year overall survival (OS) of 81% from CR1. Three different protocols were used: chemotherapy alone (n = 19), allogeneic BMT (n = 14) and an As 2O 3-based regimen (n = 21). Chemotherapy was associated with the highest treatment-related mortality (TRM) at 53%, giving a CR2 rate of 47%. TRM was 36% for BMT. The CR2 rate for the As 2O 3-based regimen was 100%, with no TRM. However, 38% of As 2O 3 treated patients had subsequent relapses, which were further salvaged in 75% by combined As 2O 3 plus ATRA. The actuarial OS for the three protocols leveled off by 2 years at 82% for As 2O 3, 43% for BMT and 23% for chemotherapy (P = 0.0004). Conclusions: Our results suggest that As 2O 3 may be superior to chemotherapy and BMT for the treatment of APL in relapse.
Persistent Identifierhttp://hdl.handle.net/10722/77889
ISSN
2015 Impact Factor: 9.269
2015 SCImago Journal Rankings: 4.362
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorAu, WYen_HK
dc.contributor.authorLie, AKWen_HK
dc.contributor.authorChim, CSen_HK
dc.contributor.authorLiang, Ren_HK
dc.contributor.authorMa, SKen_HK
dc.contributor.authorChan, CHen_HK
dc.contributor.authorMak, YKen_HK
dc.contributor.authorChen, YTen_HK
dc.contributor.authorSo, CCen_HK
dc.contributor.authorYeung, YMen_HK
dc.contributor.authorYip, SFen_HK
dc.contributor.authorWong, LGen_HK
dc.contributor.authorChan, JCen_HK
dc.contributor.authorLiu, SYen_HK
dc.contributor.authorKwong, YLen_HK
dc.date.accessioned2010-09-06T07:36:52Z-
dc.date.available2010-09-06T07:36:52Z-
dc.date.issued2003en_HK
dc.identifier.citationAnnals Of Oncology, 2003, v. 14 n. 5, p. 752-757en_HK
dc.identifier.issn0923-7534en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77889-
dc.description.abstractBackground: The best overall treatment strategy for patients with acute promyelocytic leukaemia (APL) in relapse with chemotherapy, bone marrow transplantation (BMT) or arsenic trioxide (As 2O 3) based therapy remains undefined. Patients and methods: We reviewed the clinical course and treatment outcome of 143 APL cases seen in four major hospitals in Hong Kong over a 10-year period. Results: Complete remission (CR) was attained in 113 cases (79%) with all-trans retinoic acid (ATRA) and chemotherapy. Relapse occurred at a median of 16 months in 54 cases, with a 3-year disease free survival of 56%. Post-relapse treatment was successful in 41 cases (76%), giving an actuarial 3-year overall survival (OS) of 81% from CR1. Three different protocols were used: chemotherapy alone (n = 19), allogeneic BMT (n = 14) and an As 2O 3-based regimen (n = 21). Chemotherapy was associated with the highest treatment-related mortality (TRM) at 53%, giving a CR2 rate of 47%. TRM was 36% for BMT. The CR2 rate for the As 2O 3-based regimen was 100%, with no TRM. However, 38% of As 2O 3 treated patients had subsequent relapses, which were further salvaged in 75% by combined As 2O 3 plus ATRA. The actuarial OS for the three protocols leveled off by 2 years at 82% for As 2O 3, 43% for BMT and 23% for chemotherapy (P = 0.0004). Conclusions: Our results suggest that As 2O 3 may be superior to chemotherapy and BMT for the treatment of APL in relapse.en_HK
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://annonc.oxfordjournals.org/en_HK
dc.relation.ispartofAnnals of Oncologyen_HK
dc.rightsAnnals of Oncology. Copyright © Oxford University Press.en_HK
dc.subjectAcute promyelocytic leukaemiaen_HK
dc.subjectAllogeneic bone marrow transplantationen_HK
dc.subjectArsenic trioxideen_HK
dc.subjectRelapseen_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshArsenicals - therapeutic useen_HK
dc.subject.meshBone Marrow Transplantation - statistics & numerical dataen_HK
dc.subject.meshChilden_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLeukemia, Promyelocytic, Acute - drug therapy - mortality - therapyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshOxides - therapeutic useen_HK
dc.subject.meshRecurrence - prevention & controlen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshSurvival Rateen_HK
dc.titleArsenic trioxide in comparison with chemotherapy and bone marrow transplantation for the treatment of relapsed acute promyelocytic leukaemiaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0923-7534&volume=14&spage=752&epage=757&date=2003&atitle=Arsenic+trioxide+in+comparison+with+chemotherapy+and+bone+marrow+transplantation+for+the+treatment+of+relapsed+acute+promyelocytic+leukaemiaen_HK
dc.identifier.emailChim, CS:jcschim@hku.hken_HK
dc.identifier.emailLiang, R:rliang@hku.hken_HK
dc.identifier.emailSo, CC:scc@pathology.hku.hken_HK
dc.identifier.emailKwong, YL:ylkwong@hku.hken_HK
dc.identifier.authorityChim, CS=rp00408en_HK
dc.identifier.authorityLiang, R=rp00345en_HK
dc.identifier.authoritySo, CC=rp00391en_HK
dc.identifier.authorityKwong, YL=rp00358en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1093/annonc/mdg208en_HK
dc.identifier.pmid12702530-
dc.identifier.scopuseid_2-s2.0-0038781797en_HK
dc.identifier.hkuros77750en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0038781797&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume14en_HK
dc.identifier.issue5en_HK
dc.identifier.spage752en_HK
dc.identifier.epage757en_HK
dc.identifier.isiWOS:000182736400013-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridAu, WY=7202383089en_HK
dc.identifier.scopusauthoridLie, AKW=24284842400en_HK
dc.identifier.scopusauthoridChim, CS=7004597253en_HK
dc.identifier.scopusauthoridLiang, R=26643224900en_HK
dc.identifier.scopusauthoridMa, SK=37020910400en_HK
dc.identifier.scopusauthoridChan, CH=9940314800en_HK
dc.identifier.scopusauthoridMak, YK=36841758500en_HK
dc.identifier.scopusauthoridChen, YT=7601445028en_HK
dc.identifier.scopusauthoridSo, CC=7102919978en_HK
dc.identifier.scopusauthoridYeung, YM=9941021000en_HK
dc.identifier.scopusauthoridYip, SF=7102133678en_HK
dc.identifier.scopusauthoridWong, LG=35793809000en_HK
dc.identifier.scopusauthoridChan, JC=9940606800en_HK
dc.identifier.scopusauthoridLiu, SY=7409457315en_HK
dc.identifier.scopusauthoridKwong, YL=7102818954en_HK

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