All Trans Retinoic Acid (ATRA) therapy in acute promyelocytic leukemia AML-M3 Results of treatment of 29 Iraqi adult patients with AML-M3

Khalil Al-Shemari, Ibrahim

	All Trans Retinoic Acid (ATRA) therapy in acute promyelocytic leukemia AML-M3 Results of treatment of 29 Iraqi adult patients with AML-M3
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 25, Issue 2, 2012, Pages 119-123
Author
Ibrahim Khalil Al-Shemari
Abstract
Background: All trans Retinoic acid (ATRA) when combined with chemotherapy induce complete remission in more than 85% of cases of AML-M3 , and significantly increase overall survival (OS) and Leukemia Free Survival (LFS). Aim of the study: to evaluate the efficacy of ATRA therapy in low dose (25mg/m2) together with anthracyclin-based regimen in achieving (Complete Remission) CR in patients with AML-M3. Patients and methods: Twenty nine patients with newly diagnosed AML-M3 (acute promyelocytic leukemia) based on morphology according to FAB (French-American-British) association enrolled between December2003 to June 2006. For induction of remission with ATRA therapy in dose of 25 mg/m2/day in two divided doses for 4-6 weeks along with anthracyclin-based chemotherapy and closely monitored clinically and laboratory to evaluate the response and to look for the complications . Mean follow up duration was 108 weeks. Results: Twenty nine patients with mean age of 43 year. Twenty three patients were cases of classical AML-M3 (79%) and 6 were cases of variant subtype (21%). Sixteen patients (55%) were males while 13 (45%) patients were females, Twenty one patients (73%) achieved complete remission, with induction related mortality of 27% (8 patients of 29). Three died because of ATRA syndrome, three due to sepsis and the other two because of intracranial hemorrhage, Three patients of those who achieved complete remission (CR) eventually relapsed, two within the first year of CR and died because of their disease, while the third one relapsed after one year of CR and achieved a second remission, After a median follow of 108 weeks the DFS was 86% and the OS 66%. Nine patients developed ATRA syndrome which proved to be fatal in three of them. Conclusion: ATRA therapy in a dose of 25 mg/m2/day in two divided doses with anthracyclin-based chemotherapy achieved CR in the majority of newly diagnosed adult Iraqi patients with AML-M3. Key words: AML-M3, ATRA
Keywords
AML; ATRA

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