Objective The efficacy and safety of chemotherapy-free therapy for adult non high-risk acute promyelocytic leukemia(NHR-APL)have not been validated in children,and pediatric research is needed.Methods The data came from the prospective study of the South China Children's Leukemia/Cancer Group,and NHR-APL patients who completed induction therapy were included in the analysis.The remission and adverse event rates with or without 1 dose of idarubicin/mitoxantrone 10mg/m2(chemotherapy or non-chemotherapy group)were compared,on the basis of induction therapy with arsenic and all trans retinoic acid.Results There were 139 patients in the chemotherapy group and 27 patients in the non chemotherapy group.Comparison of induction results between chemotherapy and non chemotherapy groups:the median time of hematological complete remission were 26.0(22.0,31.5)days and 31.0(27.5,35.0)days respectively(P=0.002),and there were 29.5％and 3.7％of cases achieved molecular complete remission(P=0.005).The incidence of white blood cells(WBC)＞10 × 109/L during induction was 43.2％and 74.1％(P=0.003).The median highest WBC was 8.6(4.9,18.4)× 109/L,and 22.7(16.0,41.7)× 109/L(P＜0.001).In two groups,5.8％and 33.3％of cases were diagnosed with differentiation syndrome,respectively(P＜0.001).The incidence of coagulation events was 14.4％and 51.9％(P＜0.001).In addition,the incidence of adverse events such as infection,intracranial hypertension,heart and liver disfunction,and gastrointestinal symptoms was similar in the two groups(All P＞0.1).Conclusions Pediatric APL may be different from adult patients.Compared to non chemotherapy regimen,NHR APL patients only received one dose of anthracycline during induction have better induction response and lower complications.
万方数据