All-trans retinoic acid and low-dose cytosine arabinoside for the treatment of 'poor prognosis' acute myeloid leukemia

A. Venditti, R. Stasi, G. Del Poeta, F. Buccisano, G. Aronica, A. Bruno, F. Pisani, T. Caravita, M. Masi, M. Tribalto, M. Domenica Simone, G. Avvisati, S. Amadori, G. Papa

Research output: Contribution to journalArticlepeer-review


Thirty-three patients with 'poor prognosis' acute myeloid leukemia, no longer suitable for aggressive chemotherapy, were treated with daily oral all-trans retinoic acid (45 mg/m2) daily and subcutaneous cytosine arabinoside (20 mg standard dose twice a day, day 1 to 10, every 4 weeks). Seventeen patients were males and 16 females, the median age was 67 (range 39-82 years). Eleven patients were at onset of disease, 15 were refractory to previous conventional therapies, three were in first relapse and three in second relapse and one patient had a secondary AML. Seventeen patients had a bone marrow blast infiltration <50% and 16 ≥ 50%. A total of 16 (48%) patients entered complete remission; the rate of complete remission increased to 88% in those patients (n = 17) with <50% blast infiltration at the time of entering the study. Seventeen patients (52%) were resistant. The difference in response to therapy, according to bone marrow blast percentage (<or ≥ 50%), was statistically significant (P <0.001). Median duration of complete remission was 34.4 weeks (range 6.4-62.8). Mild to moderate hematologic toxicity was the most common side-effect. In conclusion all-trans retinoic acid and low-dose cytosine arabinoside appears to be an effective regimen for inducing complete remission in 'poor prognosis' acute myeloid leukemia and patients with <50% bone marrow infiltration are likely to represent the ideal target to receive this combination therapy.

Original languageEnglish
Pages (from-to)1121-1125
Number of pages5
Issue number7
Publication statusPublished - 1995


  • AML
  • ATRA
  • Tumor burden

ASJC Scopus subject areas

  • Cancer Research
  • Hematology


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