{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:45:45Z","timestamp":1791942345163,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T00:00:00Z","timestamp":1522022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003803","name":"University of Hong Kong","doi-asserted-by":"publisher","award":["201501156911"],"award-info":[{"award-number":["201501156911"]}],"id":[{"id":"10.13039\/501100003803","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>For patients who have acute promyelocytic leukemia (APL) in second complete remission (CR2), optimal postremission strategies remain undefined.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The role of an oral arsenic trioxide (As<jats:sub>2<\/jats:sub>O<jats:sub>3<\/jats:sub>)\u2010based regimen in the management of patients who had APL in CR2 was examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Seventy\u2010three patients with APL in first relapse (R1) were studied. Oral As<jats:sub>2<\/jats:sub>O<jats:sub>3<\/jats:sub>\u2010based reinduction resulted uniformly in CR2, irrespective of previous As<jats:sub>2<\/jats:sub>O<jats:sub>3<\/jats:sub> exposure. All patients received oral As<jats:sub>2<\/jats:sub>O<jats:sub>3<\/jats:sub>\u2010based maintenance in CR2. At a median follow\u2010up of 94 months (range, 9\u2010205 months), 43 patients (58.9%) were still in CR2, and 49 (67.1%) had finished the planned 2\u2010year CR2 maintenance with all\u2010trans retinoic acid, oral As<jats:sub>2<\/jats:sub>O<jats:sub>3<\/jats:sub>, and ascorbic acid. Reinduction and maintenance treatments were well tolerated. Grade 1 and 2 headache occurred in 20 patients (27.4%). Hepatotoxicity, all in the form of transaminitis, occurred in 35 patients (47.9%; grade 1 and 2, n = 26; grade 3 and 4, n = 9). Three patients had self\u2010limiting QTc prolongation. The 10\u2010year leukemia\u2010free survival rate was 56.8%. Thirty patients developed R2. Oral As<jats:sub>2<\/jats:sub>O<jats:sub>3<\/jats:sub>\u2010based reinduction led to CR3 in 27 patients (90%). Post\u2010CR3 strategies included autologous hematopoietic stem cell transplantation and oral As<jats:sub>2<\/jats:sub>O<jats:sub>3<\/jats:sub> maintenance. At a post\u2010CR3 follow\u2010up of 30 months (range, 3\u2010166 months), 11 patients were still in CR3. The 5\u2010year and 10\u2010year overall survival rates in the R1 cohort were 79.5% and 67.3%, respectively. Prior receipt of oral As<jats:sub>2<\/jats:sub>O<jats:sub>3<\/jats:sub> maintenance in CR1 was the only risk factor for inferior leukemia\u2010free survival. Central nervous system involvement occurred in 15 patients, including 5 who remained alive. Relapse during oral As<jats:sub>2<\/jats:sub>O<jats:sub>3<\/jats:sub> therapy was the only significant risk factor for central nervous system involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>For patients with relapsed APL, As<jats:sub>2<\/jats:sub>O<jats:sub>3<\/jats:sub> remained effective despite repeated As<jats:sub>2<\/jats:sub>O<jats:sub>3<\/jats:sub> exposures. Oral As<jats:sub>2<\/jats:sub>O<jats:sub>3<\/jats:sub> maintenance was an effective postremission strategy for CR2. <jats:bold><jats:italic>Cancer<\/jats:italic> 2018;124:2316\u201026<\/jats:bold>. \u00a9 <jats:italic>2018 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.31327","type":"journal-article","created":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T15:44:26Z","timestamp":1522079066000},"page":"2316-2326","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Long\u2010term outcome of relapsed acute promyelocytic leukemia treated with oral arsenic trioxide\u2010based reinduction and maintenance regimens: A 15\u2010year prospective study"],"prefix":"10.1002","volume":"124","author":[{"given":"Harinder","family":"Gill","sequence":"first","affiliation":[{"name":"Department of Medicine Queen Mary Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Yim","sequence":"additional","affiliation":[{"name":"Department of Medicine Queen Mary Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold K. K.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine Princess Margaret Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivien","family":"Mak","sequence":"additional","affiliation":[{"name":"Department of Medicine Princess Margaret Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shek\u2010Ying","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medicine United Christian Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie","family":"Kho","sequence":"additional","affiliation":[{"name":"Department of Medicine Pamela Youde Eastern Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sze\u2010Fai","family":"Yip","sequence":"additional","affiliation":[{"name":"Department of Medicine Tuen Mun Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June S. M.","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Medicine Queen Elizabeth Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wah","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology Prince of Wales Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho\u2010Wan","family":"Ip","sequence":"additional","affiliation":[{"name":"Department of Pathology Queen Mary Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Yan","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Medicine Queen Mary Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas S. 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