Tretinoin and arsenic trioxide are both used to treat acute promyelocytic leukemia (APL). Tretinoin, which is a form of vitamin A, causes APL cells (which are immature white blood cells) to mature. Arsenic trioxide is used in patients whose APL returns after initial treatment.
The standard treatment for APL is tretinoin followed by standard chemotherapy, but the chemotherapy can raise the risk of infections, bleeding, heart damage, bone marrow damage, and a second leukemia years later. In this study, researchers want to see if giving both tretinoin and arsenic trioxide to newly diagnosed APL patients reduces the amount of standard chemotherapy needed and lowers the incidence of side effects.
The chemotherapy drug idarubicin will be given only to patients who have a high number of immature white blood cells in their bodies at the beginning of treatment or if the number of white blood cells rises during treatment.