#Promyelocytic-leukemia , focus on Auer rods. | Figure 1

Promyelocytic leukemia, focus on Auer rods.

The addition of ATRA to chemotherapy did not show differences in terms of overall survival (moderate certainty evidence).
Subgroup analyses showed there is potential benefit for ATRA in combination with a certain chemotherapeutic called decitabine, for older patients (60+ years) and for patients who already had successful chemotherapy and now receive therapy for maintenance.
For disease-free survival, complete response rate, and on-study mortality, there was probably no or little difference between treatment groups (moderate certainty evidence).
Rates of toxicities were low, therefore, the certainty of evidence is 'very low' to 'low' for the adverse events diarrhea, nausea/vomiting, and cardiac toxicity. It seems the risk of adverse events with additional ATRA is comparable to chemotherapy only (moderate certainty evidence).
The combination of ATRA probably did not lead to a higher infection rate. Regarding cardiac toxicity and diarrhea, it is uncertain whether the addition of ATRA is beneficial.
Quality of life was not reported by any of the trials.