Long-term follow-up: AML 17 trial of ATO and ATRA vs the standard of care in APL

Alan K. Burnett, MD, FRCP from Cardiff University, Cardiff, UK discusses the findings of the AML 17 randomized controlled Phase III trial comparing chemotherapy-free treatment of arsenic trioxide (ATO) and all-trans retinoic acid (ATRA) for acute promyelocytic leukemia (APL) with the standard of care, which is chemotherapy plus ATRA (ISRCTN55675535). Prof. Burnett discusses a previous Italian and German study, the GIMEMA-AMLSG-SAL trial (NCT00482833), which used a daily dosing approach in low-risk APL patients. Prof. Burnett highlights that in the AML 17 trial, high-risk patients were included and patients were given gemtuzumab ozogamicin or anthracycline at the beginning of the trial. Results from the attenuated (twice a week) dosing approach in both low-risk and high-risk patients showed less relapse and high survival. Nigel Russell, MD presented a long-term follow-up that showed no significant change in the results at the 2016 American Society of Hematology (ASH) Annual Meeting held in San Diego, CA,. This suggests it is a feasible approach to treating APL patients, irrespective of risk group, instead of using the standard chemotherapy treatment. Prof. Burnett mentions further questions for research, including questions on oral administration, drug dosage, dosing schedule, maintenance need, and whether children could also be treated with this approach.

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