{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:44:18Z","timestamp":1753868658660,"version":"3.41.2"},"reference-count":58,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T00:00:00Z","timestamp":1710892800000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Recent advances in the treatment of acute promyelocytic leukemia (APML) have seen unprecedented improvements in patient outcomes. However, such rapid growth in understanding often leads to uncertainty regarding superiority among candidate treatment regimens, especially when further scrutinized from an epidemiological perspective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this systematic review with epidemiological analysis was to identify and compare commonly utilized protocols for standard\u2010risk APML with a particular focus on complete remission (CR), overall\/disease\u2010free survival (DFS), and reported adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Medline, Scopus, and CINAHL were interrogated to identify studies utilizing all\u2010trans retinoic acid (ATRA) in addition to arsenic trioxide (ATO) and\/or anthracyclines such as idarubicin (IDA) in the treatment of de\u2010novo APML. After collation of studies, an epidemiological analysis was subsequently performed to compare protocols with regards to outcomes of interest using number needed to benefit (NNB) and number needed to harm (NNH) measures.<\/jats:p><jats:p>Seventeen articles, describing 12 distinct trials, were included in the analysis. These trials made use of three unique protocols; CR rates were 94%\u2013100% for ATO\/ATRA regimens, 95%\u201396% for ATO\/ATRA\/anthracycline regimens, and 89%\u201394% for ATRA\/anthracycline regimens. Epidemiological analysis demonstrated NNB for CR was 9.09 (ATO\/ATRA vs. ATRA\/IDA) and 20.00 (ATO\/ATRA vs. ATO\/ATRA\/IDA), NNH for neutropenia was \u22123.45 (ATO\/ATRA vs. ATRA\/IDA), and NNH for infection was \u22123.13 (ATO\/ATRA vs. ATRA\/IDA) and \u22121.89 (ATO\/ATRA vs. ATO\/ATRA\/IDA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The ATO\/ATRA regimen is superior to chemotherapy\u2010containing protocols at inducing remission and promoting survival in patients with APML. The regimen is better tolerated than the proposed alternatives with fewer adverse events. Future research opportunities include quantifying APML epidemiology and pursuing oral arsenic as an option for simplification of therapeutic protocols.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.2035","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T15:33:21Z","timestamp":1710948801000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Superiority of anthracycline\u2010free treatment in standard\u2010risk acute promyelocytic leukemia: A systematic review and comparative epidemiological analysis"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0624-3981","authenticated-orcid":false,"given":"Kane","family":"Langdon","sequence":"first","affiliation":[{"name":"College of Medicine and Dentistry James Cook University  Cairns Queensland Australia"},{"name":"Division of Medicine Cairns Base Hospital  Cairns Queensland Australia"},{"name":"Division of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stevie","family":"Cosentino","sequence":"additional","affiliation":[{"name":"Division of Medicine Cairns Base Hospital  Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia","family":"Wawryk","sequence":"additional","affiliation":[{"name":"Division of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,20]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_11_2_1","DOI":"10.3389\/fonc.2022.1026478"},{"doi-asserted-by":"publisher","key":"e_1_2_11_3_1","DOI":"10.1016\/S0140-6736(77)91415-5"},{"issue":"12","key":"e_1_2_11_4_1","first-page":"802","article-title":"The retinoic acid receptor alpha gene is rearranged in retinoic acid\u2010sensitive promyelocytic leukemias","volume":"4","author":"Chomienne C","year":"1990","journal-title":"Leukemia"},{"doi-asserted-by":"publisher","key":"e_1_2_11_5_1","DOI":"10.1038\/bcj.2015.25"},{"doi-asserted-by":"publisher","key":"e_1_2_11_6_1","DOI":"10.1182\/blood.V72.2.567.567"},{"issue":"9","key":"e_1_2_11_7_1","first-page":"3345","article-title":"Use of arsenic trioxide (As2O3) in the treatment of acute promyelocytic leukemia (APL): I. 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