Long-term outcome of using Ara-C or not in children’s APL

The use of cytarabine (Ara-C) in treating acute promyelocytic leukemia (APL) is controversial. This study was conducted to demonstrate the effect of treatment with or without Ara-C on long-term event-free survival (EFS) or overall survival (OS). All patients received all-trans retinoic acid (ATRA) +...

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Main Authors: Yingjin Zhang, Changwen Xue, Chao Wu, Wenyu Yang, Yao Zou, Ye Guo, Yumei Chen, Xiaojuan Chen, Xiaofan Zhu, Li Zhang
Format: Article
Language:English
Published: Wolters Kluwer Health 2025-06-01
Series:Blood Science
Online Access:http://journals.lww.com/10.1097/BS9.0000000000000225
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author Yingjin Zhang
Changwen Xue
Chao Wu
Wenyu Yang
Yao Zou
Ye Guo
Yumei Chen
Xiaojuan Chen
Xiaofan Zhu
Li Zhang
author_facet Yingjin Zhang
Changwen Xue
Chao Wu
Wenyu Yang
Yao Zou
Ye Guo
Yumei Chen
Xiaojuan Chen
Xiaofan Zhu
Li Zhang
author_sort Yingjin Zhang
collection DOAJ
description The use of cytarabine (Ara-C) in treating acute promyelocytic leukemia (APL) is controversial. This study was conducted to demonstrate the effect of treatment with or without Ara-C on long-term event-free survival (EFS) or overall survival (OS). All patients received all-trans retinoic acid (ATRA) + arsenic trioxide (ATO) induction therapy, followed by the course of idarubicin (IDA) and ATO, then were randomly allocated to 2 groups for consolidation therapy, with patients in the daunorubicin (DNR) group received DNR, in the DNR + Ara-C (DA) group received DNR + Ara-C. Maintenance therapy consisted of oral ATRA, 6-mercaptopurine, and methotrexate for 1.5 years. Thirty patients in DA group and 35 patients in DNR group, all achieved complete remission. At follow-up, there was 1 death and 3 relapses in DNR group, compared to none in DA group. There was no statistically significant difference in EFS (P = 0.140) and OS (P = 0.398) between 2 groups, with EFS being 100% in DA group and 91.4% ± 0.047 in DNR group, and OS being 100% in DA group and 97.1% ± 0.028 in DNR group. Our study found no prognostic significance of Ara-C, this may be related to the small sample size. We still recommend the addition of Ara-C during treatment, which has a more positive impact on early remission and late prognosis of patients.
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spelling doaj-art-9ee3b537cd8e4f70b3e5452ead33c5642025-08-20T02:20:16ZengWolters Kluwer HealthBlood Science2543-63682025-06-0172e0022510.1097/BS9.0000000000000225202506000-00010Long-term outcome of using Ara-C or not in children’s APLYingjin Zhang0Changwen Xue1Chao Wu2Wenyu Yang3Yao Zou4Ye Guo5Yumei Chen6Xiaojuan Chen7Xiaofan Zhu8Li Zhang9a State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, Chinaa State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, Chinaa State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, Chinaa State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, Chinaa State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, Chinaa State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, Chinaa State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, Chinaa State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, Chinaa State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, Chinaa State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaThe use of cytarabine (Ara-C) in treating acute promyelocytic leukemia (APL) is controversial. This study was conducted to demonstrate the effect of treatment with or without Ara-C on long-term event-free survival (EFS) or overall survival (OS). All patients received all-trans retinoic acid (ATRA) + arsenic trioxide (ATO) induction therapy, followed by the course of idarubicin (IDA) and ATO, then were randomly allocated to 2 groups for consolidation therapy, with patients in the daunorubicin (DNR) group received DNR, in the DNR + Ara-C (DA) group received DNR + Ara-C. Maintenance therapy consisted of oral ATRA, 6-mercaptopurine, and methotrexate for 1.5 years. Thirty patients in DA group and 35 patients in DNR group, all achieved complete remission. At follow-up, there was 1 death and 3 relapses in DNR group, compared to none in DA group. There was no statistically significant difference in EFS (P = 0.140) and OS (P = 0.398) between 2 groups, with EFS being 100% in DA group and 91.4% ± 0.047 in DNR group, and OS being 100% in DA group and 97.1% ± 0.028 in DNR group. Our study found no prognostic significance of Ara-C, this may be related to the small sample size. We still recommend the addition of Ara-C during treatment, which has a more positive impact on early remission and late prognosis of patients.http://journals.lww.com/10.1097/BS9.0000000000000225
spellingShingle Yingjin Zhang
Changwen Xue
Chao Wu
Wenyu Yang
Yao Zou
Ye Guo
Yumei Chen
Xiaojuan Chen
Xiaofan Zhu
Li Zhang
Long-term outcome of using Ara-C or not in children’s APL
Blood Science
title Long-term outcome of using Ara-C or not in children’s APL
title_full Long-term outcome of using Ara-C or not in children’s APL
title_fullStr Long-term outcome of using Ara-C or not in children’s APL
title_full_unstemmed Long-term outcome of using Ara-C or not in children’s APL
title_short Long-term outcome of using Ara-C or not in children’s APL
title_sort long term outcome of using ara c or not in children s apl
url http://journals.lww.com/10.1097/BS9.0000000000000225
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