Abstract
OBJECTIVE:
Arsenic has become first-line treatment of acute promyelocytic leukemia (APL) since 2013 according to NCCN Guidelines Acute Myeloid Leukemia Version 2.2013, but little information is available about the real world of arsenic uses in China. We aimed to evaluate the usage of arsenic and assess the current status of the treatment of APL in China.
METHODS:
Noninterventional, cross-sectional survey using electronic questionnaires distributed to APL patients and answered anonymously.
RESULTS:
In total, 237 respondents were evaluable and 120 respondents (50.6%) were male. Median age was 40 years (range 15-68 years). Median time from diagnosis to this survey was 15 months. Valid submissions came from 28 of 34 provinces and municipalities. There were 77.64% respondents hospitalized within three days since diagnosis. The percentage of respondents received arsenic during induction treatment was 73.8% (175/237), including arsenic trioxide (ATO) (n=136) and oral arsenic (n=39). However, the percentage increased up to 100% (237/237) during the post-remission treatment phase, including ATO (n=137) and oral arsenic (n=100). Interestingly, 32.9% respondents considered the costs of ATO acceptable by themselves. However, 92.4% respondents regarded the burden of oral arsenic was high because it was not covered by health insurance, and 95.8% respondents appeal to oral arsenic covered by health insurance. The proportion of respondents covered by Basic Insurance for Urban Employees, Basic Insurance for Urban Residents, the New Rural Cooperative Medical Scheme and Commercial insurance were 3.8%, 44.3%, 38.4% and 5.9%. In total, 99.16% respondents hope to receive a chemotherapy-free outpatient treatment protocol
CONCLUSIONS:
High proportion of APL patients received arsenic as first-line treatment in China, which may result from the relative low price of arsenic. A chemotherapy-free outpatient treatment model worthy to explore.
No relevant conflicts of interest to declare.
Author notes
Asterisk with author names denotes non-ASH members.
