First experience of the AML-Berlin-Frankfurt-Münster group in pediatric patients with standard-risk acute promyelocytic leukemia treated with arsenic trioxide and all-trans retinoid acid.

STUDY AIM

To help decide which strategy should be used to treat low-risk APL pediatric patients.

Methods

The authors report on first line experience of 11 pediatric patients with low-risk APL treated with ATRA and ATO.

Results

All patients stayed in molecular remission. All suffered from hyperleukocytosis. Two patients experienced reversible severe side effects. One suffered from osteonecroses at both femurs, seizures, as well as posterior reversible encephalopathy syndrome, the other patient had an abducens paresis.

Conclusion

The data suggest that it is still unknown which strategy should be followed, either starting cautiously with ATO on day 10 or beginning earlier with ATRA and ATO together.

The authors believe that the new ATRA-ATO treatment should only take place in experienced clinics accompanied by expert consultation.