Background: Acuts promyelocytic leukemia(APL, AML M3 in FAB classification) that represents 5% to 15% of cases of acute myeloid leukemia(AML), is a distinct subtype of
acute mysloid leukemia in morphologic feature, genetic rearrangement like t(15;17), PML-RARα, associated coagulopathy and good response to induction therapy by
all-fans-retinoic acid(ATRA). The longterm outcome of APL treatment using ATRA as remission induction followed by consolidation chemotherapy has been reported extremely
rarely in Korea.
Methods: Patisnts diagnosed as APL from March 1993 to October 1996 were assigned to receivs induction thsrapy wlth ATRA and consolidation chemotherapy with combination chemotherapy(scheduled as Ara-C+DNR, Mit+Ara-C, Ida+Ara-C), followed up till July 1997(median F/U duration : 25.7 months) to yield complete remission rate, disease-free survival, overall survival and side effects.
Results: The 21 patients, who has not been previously treated, were with median age of 45 years(range 17 to 63 years), and with sex ratio of 1.1:1. After induction by
ATRA, CR was obtained in 16(CR rats:88.9%) out of 18 evaluable cases. CR was maintained in 9 cases, whereas 2 cases were dead during consolidation therapy, and relapse were found in 5 cases after consolidation chemotherapy among 16 cases who gained remission. Disease-free survival was 33.9 months(3.9∼48.8), the estimated disease-free survival at 1, 2, 3 years were 73.8, 48.9, 46.9 percent respectively. The estimated overall survival rate at 1, 2, 3 ysars were 66.3, 64.2, 64.2 percent respectively.
The side effects associated with ATRA treatment were obsevsd in 12 cases(ATRA syndrome were 2 cases), and severe coagulopathy(intracranial hemorrhage) was in 1 case who was dead on day 5.
Conclusion: In conclusion, the remission induction therapy with ATRA followed by consolidation chemotherapy resultsd in less severs complication, lower relapse rate, prolonged dissase-free survival and overall survival than the conventional chemotherapy in acuts promyelocytic leukemia.

Keywords: Acute promyelocytic leukemia, All-trans-retinoic acid(ATRA)