CALGB 9710

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Regimen

Induction therapy

All trans retinoic avid (ATRA) 45 mg/m2 po qd in 2 divided doses d1 till hematologic CR
Cytarabine (Ara-C) 200 mg/m2/d civi d3-9
Daunorubicin 50 mg/m2/d iv d3-6

Consolidation therapy

Arsenic Trioxide (As2O3) 0.15 mg/kg/d x 5d/week for 5 wks x 2 cycles (cycle 2 starts after 2 wks rest)
followed by
ATRA 45 mg/m2 po qd in 2 divided doses d1-7 x 2 cycles
Daunorubicin 50 mg/m2/d iv d1-3 x 2 cycles

Maintenance therapy

ATRA 45 mg/m2 po qd in 2 divided doses d1-7 qow x 1 year
6-Mercaptopurine (6-MP) 60 mg/m2 po qd x 1 year
Methotrexate (MTX) 20 mg/m2 po qw x 1 year


References

Fenaux, P et al. Effect of all trans retinoic acid in newly diagnosed acute promyelocytic leukemia. Results of a multicenter randomized trial. European APL 91 Group. Blood 1993; 82:3241
Powell BL et al. Effect of consolidation with arsenic trioxide (As2O3) on event-free survival (EFS) and overall survival (OS) among patients with newly diagnosed acute promyelocytic leukemia (APL): North American Intergroup Protocol C9710. 2007 ASCO annual meeting. Abstract 2.
Tallman, MS et al. Acute promyelocytic leukemia: evolving therapeutic strategies. Blood 2002; 99:759
Tallman, MS et al. All-trans-retinoic acid in acute promyelocytic leukemia. N Engl J Med 1997; 337:1021.
Tallman, MS et al. All-trans retinoic acid in acute promyelocytic leukemia: long-term outcome and prognostic factor analysis from the North American Intergroup protocol. Blood 2002; 100:4298.