Abstract 790P
Background
All-trans retinoic acid (ATRA), arsenic trioxide(ATO), and daunorubicin(DNR) therapy, followed by ATRA and arsenic trioxide consolidation therapy, have been found beneficial for treating adults with high-risk acute promyelocytic leukemia (APL). However, it remains unclear whether similar regimens are both safe and beneficial for treating high-risk APL in pediatric patients.
Methods
In this retrospective study, we included 19 of 30 patients up to 18 years with newly diagnosed high risk acute promyelocytic leukemia from a quaternary care center in South India (Vijayawada between January 2015 to December 2023 treated with ATRA, ATO and with or without DNR in induction followed by ATRA and ATO consolidation.
Results
Among 19 high risk APML patients included in this study, there were 10 boys and 9 girls. 11 achieved complete remission with a median duration of 24 days, 7 patients died. (6 IC bleed, 1 renal failure) before starting ATRA, ATO and DNR, 1 patients died (Ileal bleed) during induction. No Differentiation syndrome occurred in high risk patients. One patient had QT prolongation requiring treatment modification. On long-term follow-up of patients who achieved complete remission, none developed relapse, on follow up of 8-year relapse rates were zero.
Conclusions
This study demonstrated that the combination of All-Trans-Retinoic acid, Arsenic trioxide, and variable doses of Daunorubicin for induction, followed by All-Trans-Retinoic acid and Arsenic trioxide for consolidation in high-risk Pediatric Acute Promyelocytic Leukemia, yielded favorable outcomes. The translation of adult data to the pediatric population has been successful in pediatric Acute Promyelocytic Leukemia (APL).
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.