LaBella, DominicRegan, SamuelKonig, HeikoEgan, Daniel N.Bailey, Neil A.Mawad, RayaGilbert, MorganPagel, John M.Pu, Jeffrey J.2023-08-092023-08-092022-08-03LaBella D, Regan S, Konig H, et al. The role of adjuvant chemotherapy in the management of acute promyelocytic leukemia differentiation syndrome. Front Oncol. 2022;12:911745. Published 2022 Aug 3. doi:10.3389/fonc.2022.911745https://hdl.handle.net/1805/34809Acute 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.en-USAttribution 4.0 InternationalAcute Promyelocytic LeukemiaAll-Trans-Retinoic Acid (ATRA)Arsenic Trioxide (ATO)Differentiation Syndrome (DS)Adjuvant ChemotherapyArticle