SynthesisBMC cancer2026
Efficacy and safety of ATRA plus arsenic trioxide versus ATRA plus chemotherapy in newly diagnosed acute promyelocytic leukemia: a grade-assessed systematic review and meta-analysis.
Synthesis in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute promyelocytic leukemia (APL) is an aggressive malignancy. Although recent advancements in therapy have improved outcomes, differing toxicity profiles remain. The optimal choice between all-trans retinoic acid plus arsenic trioxide (ATRA + ATO) and ATRA plus chemotherapy, in newly diagnosed APL remains uncertain.
methodsA systematic literature search was conducted across databases PubMed (n = 812), Embase (n = 975), Scopus (n = 894), and the Cochrane Library (n = 300) for studies comparing ATRA + ATO with ATRA+chemotherapy in newly diagnosed APL. Of 2981 records found, 681 duplicates were removed, leaving 2300 records for screening. After a full-text review of 100 reports, 12 studies met the inclusion criteria. Data were analyzed using random- and fixed-effects models, with subgroup and sensitivity analyses performed to assess heterogeneity. The certainty of evidence for each outcome was assessed using the GRADE framework. Findings from RCTs are primary basis for conclusion.
resultsIn RCTs, ATRA + ATO significantly improved complete remission rates (risk ratio [RR] 1.04, 95% CI 1.02–1.06), disease-free survival (RR 1.22, 95% CI 1.11–1.34), event-free survival (RR 1.25, 95% CI 1.20–1.29) and overall survival (RR 1.07, 95% CI 1.03–1.12) compared with ATRA+chemotherapy.observational studies showed showed consistent findings supporting real world generalizability. A trend toward lower gastrointestinal toxicity was observed with ATRA + ATO (RR 0.28, 95% CI 0.07–1.18), but it was not statistically significant. There were no significant differences in hepatic toxicity, differentiation syndrome or thrombocytopenia. ATRA + ATO was associated with an increased risk of QTc prolongation (RR 3.79, 95% CI 1.00–14.36, p = 0.05). The under-reporting in the primary studies limits the ability to draw a definitive conclusion on the difference in reported cardiac event rates in the clinics.
conclusionsCompared with ATRA plus chemotherapy, ATRA + ATO is associated with superior remission and survival outcomes in newly diagnosed APL, with lower gastrointestinal toxicity but higher risk of QTc prolongation. These findings support the preferential clinical use of ATRA + ATO with close cardiac monitoring. REGISTRATION: The systematic review was registered with the International Prospective Register Of Systematic Reviews (PROSPERO Registration No. CRD420251164171).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.