Treatment Without Chemotherapy Effective for Leukemia Patients in Study

A group of Italian and German researchers has found that people with a certain type of leukemia can be successfully treated without using chemotherapy, which can cause serious side effects.

The study included 156 people with acute promyelocytic leukemia, a type of acute myeloid leukemia (AML), which is a cancer of the blood. Most patients treated for this type of AML – about 80% to 90% – go into remission, meaning all signs of their cancer go away, or are cured. Treatment usually involves a chemotherapy drug plus all-trans-retinoic acid (ATRA), a drug related to vitamin A. Patients who are not able to tolerate chemotherapy usually get ATRA plus a drug called arsenic trioxide.

In the study, published in the July 11, 2013 issue of the New England Journal of Medicine, researchers compared these 2 drug combinations in patients with low- to intermediate-risk levels of the disease. They wanted to test whether patients taking ATRA plus arsenic trioxide would do as well as patients taking ATRA plus chemotherapy, thereby avoiding the side effects from chemotherapy.

The patients who skipped chemotherapy actually did slightly better than the ones who got chemotherapy. More people in the ATRA-arsenic trioxide group survived than in the ATRA-chemotherapy group, and slightly more went into complete remission.

Chemotherapy drugs are often used to treat cancer, but these drugs can be powerful and have serious side effects. Chemotherapy used to treat acute promyelocytic leukemia patients affects the bone marrow, which often causes low blood cell counts. This can lead to increased risk of infections, easy bruising or bleeding, and fatigue. Using ATRA with arsenic trioxide instead of chemotherapy causes less problems with low blood counts and infections, but can cause liver problems in some people.

The researchers plan longer follow-up to confirm their findings.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Retinoic Acid and Arsenic Trioxide for Acute Promyelocytic Leukemia. Published in the July 11, 2013 issue of the New England Journal of Medicine. First author: Francesco Lo-Coco, MD, Dipartimento di Biomedicina e Prevenzione, Rome, Italy.

American Cancer Society news stories are copyrighted material and are not intended to be used as press releases. For reprint requests, please see our Content Usage Policy.