{"doi":"10.3389/fonc.2022.911745","title":"The role of adjuvant chemotherapy in the management of acute promyelocytic leukemia differentiation syndrome","abstract":"Acute Promyelocytic Leukemia (APL) is characterized by the t(15;17) chromosomal translocation resulting in a PML-RARA fusion protein. The all-trans-retinoic acid (ATRA) and Arsenic Trioxide (ATO) only regimens have demonstrated success in treating low- and intermediate-risk patients. However, induction with ATRA/ATO only regimens have been showing increased incidence of differentiation syndrome (DS), a potentially lethal complication, traditionally treated with dexamethasone. We conducted a three-institution retrospective study, aiming to evaluate the role of short-term adjuvant chemotherapy in managing moderate DS for patients with low- or intermediate-risk APL initially treated with ATRA/ATO only protocols. We evaluated the difference in incidence and duration of moderate DS in APL patients who were treated with ATRA/ATO with or without adjuvant chemotherapy. 57 low- or intermediate-risk APL patients were retrospectively identified and included for this study; 36 patients received ATRA/ATO only induction treatment, and 21 patients received ATRA/ATO/adjuvant chemotherapy combination induction therapy. Similar proportions of patients experienced DS in both groups (66.7% vs. 81.0%, P = 0.246). The median duration of DS resolution in patients receiving ATRA/ATO only was 17 days (n = 23), and in patients receiving combination therapy was 8 days (n = 16) (P = 0.0001). The lengths of hospital stay in patients receiving ATRO/ATO only was 38 days (n = 7), and in patients receiving combination therapy was 14 days (n = 17) (P = 0.0007). In conclusion, adding adjuvant chemotherapy to ATRA/ATO only protocol may reduce the duration of DS and the length of hospital stay during APL induction treatment.","journal":"Frontiers in Oncology","year":2022,"id":292607,"datarank":0.20794415416798362,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.0,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9495,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":976696,"name":"Samuel N. Regan","orcid":"0000-0002-5449-8348","position":1,"is_corresponding":false},{"id":286863,"name":"Heiko Konig","orcid":null,"position":2,"is_corresponding":false},{"id":976697,"name":"Daniel Egan","orcid":"0000-0002-0523-1188","position":3,"is_corresponding":false},{"id":233555,"name":"Neil A. Bailey","orcid":"0000-0002-3809-3236","position":4,"is_corresponding":false},{"id":977115,"name":"Raya Mawad","orcid":null,"position":5,"is_corresponding":false},{"id":976698,"name":"Morgan D. Gilbert","orcid":"0000-0003-0219-3902","position":6,"is_corresponding":false},{"id":234676,"name":"John M. Pagel","orcid":null,"position":7,"is_corresponding":false},{"id":233545,"name":"Jeffrey J. Pu","orcid":"0000-0001-7498-3159","position":8,"is_corresponding":false},{"id":110324,"name":"Dominic LaBella","orcid":"0000-0003-1713-9538","position":0,"is_corresponding":true}],"reference_count":7,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T00:30:46.209549Z","pmid":"35992790","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}