All trans-retinoic acid decreases early mortality in patients with promyelocytic leukemia and can be given entirely on an outpatient basis

The results of the treatment of 43 patients with acute promyelocytic leukem ia (PML) are reported: 27 were treated initially with all-trans-retinoic ac id (ATRA), whereas 16 were treated with conventional chemotherapy. All pati ents received myelosuppressive chemotherapy after the initial treatment, Re spectively, the complete remission rate was 92% and 37% (P < 0.01), the B-d ay mortality rate was 0% and 44% (P < 0.001), and the 28-day mortality rate was 4% and 44% (P < 0.001). The median disease-free survival was 12 and 1 months (P < 0.01), whereas the 12-month disease-free survival was 50% and 1 3% (P < 0.01) and the 36-month disease-free survival was 41% and 9% (P < 0. 01), Thirteen of the patients treated with ATRA were given the treatment fu lly as outpatients. ATRA given as initial therapy decreased significantly e arly mortality in promyelocytic leukemia patients; because some promyelocyt ic leukemia patients given ATRA as initial therapy can be treated as outpat ients, the costs of this treatment modality may be diminished. (C) Wiley-Li ss, Inc.