Induction therapy |
ATRA 45 mg/m2 PO per day in two divided doses until CR plus an anthracycline (eg, daunorubicin or idarubicin) with or without added cytarabine. The optimal dose of daunorubicin in this setting has not been clarified (see text). |
Consolidation |
Two 25-day cycles of arsenic trioxide (0.15 mg/kg IV per day for five days each week for five weeks each) followed by two cycles of the combination of daunorubicin (50 mg/m2 IV daily for three days) plus ATRA (45 mg/m2 per day orally days 1 through 7). |
Maintenance |
ATRA 45 mg/m2 PO daily on an intermittent schedule (eg, 15 days every three months or 7 days every two weeks) for one year. |
Follow-up |
PCR for the PML/RARa fusion gene on a bone marrow specimen every three months for one year. Monitoring of peripheral blood may be a reasonable alternative. Relapses can occur between scheduled bone marrow studies and late relapses (ie, >4 years) may be observed. |
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