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The first part of cytarabine medication or purpose to explore the Cochrane systematic review of acute promyelocytic leukemia therapeutic effect of Ara-C (cytarabine, Ara-C) in the treatment of acute promyelocytic leukemia (acute promyelocytic leukemia, APL) efficacy and safety evaluation of the application of Ara-C or not APL treatment effect. Cochrane systematic review methods, inspection data and methods at home and abroad have been published or unpublished comparison with and without treatment of Ara-C program APL efficacy randomized controlled trials (randomized controlled trials, RCT) literature, event-free survival (event free survival, EFS), overall survival (overla survival, OS), disease-free survival (disease free survival, DFS), complete response rate (complete remission, CR), the induction period mortality, chemotherapy-related toxicity reaction, relapse rate (relapse rate, RR) such as the evaluation index, using The Cochrane Collaboration RevMan5.0 software Meta-analysis. Include the results of the three RCTs including a total of 504 cases of subjects. The results showed that the impact of differences of plus Ara-C APL patients EFS, OS and CR was not statistically significant, its effect statistic hazard ratio and 95% confidence intervals were 1.21 (0.93,1.59), 1.02 (0.80 , 1.31) and 1.51 (0.17,13.45); impact of the incidence of mortality of APL patients during the induction period plus Ara-C and chemotherapy-related toxicity reactions no statistically significant differences than value than its effect Statistics and 95% confidence interval were 1.26 (0.70,2.29), 6.91 (0.15,315.6); impact on DFS is not obvious. Plus Ara-C RR is still controversial. Conclusion Based on the results of a meta-analysis of 3 RCTs, APL chemotherapy Ara-C did not show evidence of improving efficacy. The current evidence is insufficient to recommend Ara-C for APL conventional chemotherapy. Cochrane systematic review Objective To evaluate the second part of arsenic trioxide in acute promyelocytic leukemia treatment in the role of the Cochrane systematic review (1) Arsenic trioxide single-agent treatment of acute promyelocytic leukemia monotherapy APL, arsenic trioxide (arsenic trioxide, ATO) The efficacy and safety. Cochrane systematic review of data and methods, the Cochrane Library Controlled Trials Register databases (Cochrane Central Register of Clinical Trials, CENTRAL), MEDLINE, EMBASE, Chinese Biomedical Literature Database (CBM), China Journal Net thematic text Database (CNKI), Chinese Medicine Conference Papers Database (CMAC), supplemented by manual searches and additional search and retrieval time as of 2009 in March. Get more including without ATO treatment program the APL efficacy RCT literature to CR, OS, DFS, the start of treatment to the time achieved CR, RR, mortality and treatment-related side effects, using the Cochrane Collaboration Evaluation The software of Revman5.0 the meta analysis. Include the results of five RCTs including a total of 328 cases of APL patients, including four studies moderate risk of bias, one study there is a high risk of bias. Research purposes are based on all-trans retinoic acid (all-trans retinoic acid, ATRA) treatment associated with the ATO and ATRA comparison of single-agent failed to retrieve the RCT ATO compared with placebo or observation. The results showed that, plus ATO to begin treatment for newly diagnosed APL patients to influence the effect achieved CR Statistics volume difference (mean difference, MD) and its 95% CI -1.20 days (-1.68, -0.72); the effect statistic two years DFS impact risk ratio (hazard ratio, HR) and its 95% CI 8.37 (1.64,42.60); edema incidence for patients during treatment RR, and extended ECG corrected QT interval incidence the impact effect statistics compared to value ratio (odds ratio, OR) and its 95% CI were 0.19 (0.08,0.49), 4.16 (1.46,11.79) and 22.10 (2.75,177.49); remaining outcome results of a meta-analysis of the differences were No statistically significant. Conclusion Compared with ATRA monotherapy program, plus ATO can shorten newly diagnosed APL patients starting treatment achieved CR, improve the DFS and reduce RR, but may lead to QT prolongation during treatment of patients with edema and ECG corrected The increase in the incidence. The restrictions included in the test quality and number of cases, the conclusions need to be confirmed by further studies. Section II of arsenic trioxide and all-trans retinoic acid treatment of acute promyelocytic leukemia efficacy comparison purpose Cochrane systematic review comparing the ATO and ATRA treatment of APL efficacy and security. Materials and Methods Cochrane systematic review, Cochrane Library CENTRAL, MEDLINE, EMBASE, CBM, CNKI and CMAC, supplemented by manual searches and additional search and retrieval time as of 2009 in March. Get the ATO and ATRA treatment of APL efficacy RCT literature start to get the time of the CR to CR, OS, DFS, treatment the RR, mortality and treatment-related adverse outcome evaluation, using the the Cochrane Collaboration Revman5.0 software Meta-analysis. Results were identified and included in the four RCTs including a total of 243 APL patients, study bias risk assessment for all moderate bias research purposes are relatively ATO efficacy and side effects of the treatment of APL with ATRA happens. Meta-analysis results show that the ATO with ATRA-naive treatment of APL compared no statistically significant differences for CR, relapse rate, mortality outcomes, these outcomes OR and 95% CI were 0.96 (0.50,1.86) 0.86 (0.45,1.63) and 1.15 (0.45,2.95); starting treatment time outcomes achieved CR no significant difference between the MD and 95% CI for 0.60 d (-12.34,13.53); difference of DFS not statistically significant, the HR and 95% CI of 2.76 (0.71,10.66). The comparison rate outcome for liver function abnormalities occurred OR and 95% CI 3.03 (1.25,7.37), the difference was statistically significant. Conclusion Meta-analysis results suggest that ATO with ATRA treatment of newly diagnosed APL patients from the CR, RR, mortality and DFS indicators compare the efficacy, but the ATO may lead to increase in the incidence of abnormal liver function. Cochrane systematic review of Section III of arsenic trioxide combined with all-trans retinoic acid treatment of acute promyelocytic leukemia Objective To evaluate the ATO United efficacy of ATRA treatment of APL. Materials and Methods Cochrane systematic review, Cochrane Library CENTRAL, MEDLINE, EMBASE, CBM, CNKI and CMAC, supplemented by manual searches and additional search and retrieval time as of 2009 in March. Get research the ATO joint ATRA program treatment of APL efficacy of RCT literature, CR, OS, DFS, the start of treatment to the time of CR, RR, mortality and adverse outcome evaluation, use The Cochrane Collaboration Revman5.0 software meta-analysis. Results A total of seven RCTs including 392 subjects. Moderate risk of bias six studies, one study there is a high risk of bias. Research programs including programs ATO combination ATRA and ATO single-agent, the ATRA single drug and ATO ATRA, chemotherapy compared RCT compared with the current preferred option (ATRA anthracyclines) could not be retrieved. Meta-analysis of the results shows, ATO single drug, a joint program to improve the newly diagnosed APL patients begin treatment time and RR of CR, no statistically significant impact on the rest of the outcome, the subjects disease states (de novo or sensitivity analysis of the criteria for the classification of CR, DFS, mortality and liver dysfunction incidence of recurrence), the results of the overall meta-analysis results; comparison with ATRA single drug, the joint program to improve the newly diagnosed APL patients began treatment to CR the time, DFS, and RR, but may lead to the increased incidence of edema; compared with the ATO ATRA chemotherapy, the joint program of newly diagnosed APL patients with CR, relapse rate, mortality and treatment-related side effects such as outcome indicators have certain improvement. Conclusions For patients with newly diagnosed APL, ATO combined with ATRA program efficacy superior to ATO single-agent, the ATRA single drug, and ATO ATRA chemotherapy, but due to the lack of comparable data diagnosed APL patients early with the current standard therapy (ATRA anthracyclines), yet insufficient to recommend ATO combined with ATRA program used in the treatment of patients newly diagnosed APL. For patients with relapsed APL, ATO combined with ATRA program was not superior to the ATO single-agent, that the evidence does not yet support the use of ATRA plus on the basis of the ATO monotherapy. Quality, the number of cases of restrictions included in the study, the conclusions of the analytical needs cautious, and an urgent need for further studies to test.
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