Induction Treatment
The details of treatment protocol were published.1During induction therapy, patients received ATRA at 25mg/(m2·d) as soon as morphology diagnosis of APL was made. Mitoxantrone (MA) was administrated on day 3 (10mg/m2) or day 2-4 (7mg/ (m2·d) of ATRA treatment for NHR or high risk (HR) patients (diagnostic WBC count >10 × 109/L) respectively. Once the diagnosis was genetically confirmed (5-6 days later), the patients were randomized to ATO or RIF group. ATO was administrated at 0.16mg/(kg·d) (≯10 mg/day) intravenously over 12 hours daily, while RIF was given at 135mg/(kg·d) (≯30 pills/day) orally three times daily, until complete remission was achieved.
When WBC exceeded 10×109/L at the beginning of or during induction treatment, hydroxyurea was administrated at 100mg/(kg·d). Dexamethasone at 0.3 mg/(kg·d) was given if differentiation syndrome or ATRA-associated pseudotumor cerebri was suspected. Transfusions of platelet, and fresh-frozen plasma, cryoprecipitate and/or human fibrinogen (Fbg), were given for the aims of maintaining platelet counts (PLT) greater than 30 × 109/L, and Fbg greater than 1.5g/L, respectively. The use of heparin or low-molecular weight heparins for management of coagulopathy depended on doctors’ clinical judgment.