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The efficacy of RIF is similar to that of arsenic trioxide (ATO). However, the effects of these two arsenicals on differentiation syndrome (DS) and coagulation disorders, the two main life-threatening events in children with APL, remain unclear. We retrospectively analyzed 68 consecutive children with APL from South China Children Leukemia Group-APL (SCCLG-APL) study. Patients received all-trans retinoic acid (ATRA) on day 1 of induction therapy. ATO 0.16\u00a0mg\/kg day or RIF 135\u00a0mg\/kg\u00b7day was administrated on day 5, while mitoxantrone was administered on day 3 (non-high-risk) or days 2\u20134 (high-risk). The incidences of DS were 3.0% and 5.7% in ATO (<jats:italic>n<\/jats:italic>\u2009=\u200933) and RIF (<jats:italic>n<\/jats:italic>\u2009=\u200935) arms (<jats:italic>p<\/jats:italic>\u2009=\u20090.590), and 10.3% and 0% in patients with and without differentiation-related hyperleukocytosis (<jats:italic>p<\/jats:italic>\u2009=\u20090.04), respectively. Moreover, in patients with differentiation-related hyperleukocytosis, the incidence of DS was not significantly different between ATO and RIF arms. The dynamic changes of leukocyte count between arms were not statistically different. However, patients with leukocyte count\u2009&gt;\u20092.61\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L or percentage of promyelocytes in peripheral blood\u2009&gt;\u200926.5% tended to develop hyperleukocytosis. The improvement of coagulation indexes in ATO and RIF arms was similar, with fibrinogen and prothrombin time having the quickest recovery rate. This study showed that the incidence of DS and recovery of coagulopathy are similar when treating pediatric APL with RIF or ATO.<\/jats:p>","DOI":"10.1007\/s00277-023-05270-x","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T05:01:42Z","timestamp":1684386102000},"page":"1713-1721","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Differentiation syndrome and coagulation disorder \u2014 comparison between treatment with oral and intravenous arsenics in pediatric acute promyelocytic leukemia"],"prefix":"10.1007","volume":"102","author":[{"given":"Jie-Si","family":"Luo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Li","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan-Ping","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Qiao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wu-Qing","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Rong","family":"Mai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Qin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ri-Yang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo-Hua","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue-Qun","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Lai","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8123-0235","authenticated-orcid":false,"given":"Li-Bin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,5,18]]},"reference":[{"issue":"9","key":"5270_CR1","doi-asserted-by":"publisher","first-page":"e357","DOI":"10.1016\/S2352-3026(15)00115-5","volume":"2","author":"Iland HJPC, Group ALAL","year":"2015","unstructured":"Iland HJPC, Group ALAL (2015) Use of arsenic trioxide in remission induction and consolidation therapy for acute promyelocytic leukaemia in the Australasian Leukaemia and Lymphoma Group (ALLG) apml4 study: a non-randomised phase 2 trial. 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