Short-term intensive consolidation therapy after all-trans retinoic acid in acute promyelocytic leukemia

Complete remission induced by all-trans retinoic acid (ATRA) in acute promy elocytic leukemia is short lived, and several consolidation chemotherapy co urses usually are given to reduce the relapse rate. To assess the value of short-term intensive consolidation, 38 patients with newly diagnosed acute promyelocytic leukemia entered a prospective study in which induction thera py with ATRA immediately was followed by a single course of mitoxantrone pl us high-dose cytarabine (3 g/m(2) every 12 hours, days 1-4), with no furthe r treatment. Complete remission was achieved in 31 patients (81.6%) after a median time of 49 days of ATRA (to which chemotherapy was added at entry i n 10 patients with leukocytosis). Thirty patients received the planned cons olidation course. After a median follow-up of 36 months, four of these pati ents have relapsed and 24 are still in first complete omission, for an esti mated disease-free survival of 75% at 60 months. The authors conclude that this single course consolidation of ATRA-induced remission provides excelle nt long-term control of acute promyelocytic leukemia.