6533b82efe1ef96bd12932e2

RESEARCH PRODUCT

Conventional induction and post-remission therapy in APL: have we arrived?

Gloria IacoboniMiguel A. SanzPau Montesinos

subject

OncologyAcute promyelocytic leukemiaDrugmedicine.medical_specialtyHarringtoninesAnthracyclinemedia_common.quotation_subjectmedicine.medical_treatmentClinical BiochemistryTretinoinPharmacologyArsenicalsTargeted therapyMaintenance Chemotherapychemistry.chemical_compoundArsenic TrioxideLeukemia Promyelocytic AcuteInternal medicineAntineoplastic Combined Chemotherapy ProtocolsmedicineHumansMulticenter Studies as TopicAnthracyclinesRelapse riskArsenic trioxidemedia_commonChemotherapyClinical Trials as Topicbusiness.industryMercaptopurineDaunorubicinRemission InductionMyeloid leukemiaOxidesmedicine.diseaseConsolidation ChemotherapyMethotrexateOncologychemistryMitoxantronebusinessHomoharringtonineIdarubicin

description

Since the introduction of all-trans-retinoic acid, the use of this molecularly targeted treatment in combination with anthracycline-based chemotherapy has completely changed the prognosis of acute promyelocytic leukemia (APL) turning it into the most curable acute myeloid leukemia. Also, the use of risk-adapted protocols has optimized the drug combination and the most appropriate dose intensity for each subset of patients classified according to both risk of relapse and vulnerability to drug toxicity. Recent developments have included the investigation of the role of arsenic trioxide (ATO) as front-line treatment after its success in relapsed APL, both to minimize or even omit the use of cytotoxic agents and to reinforce the conventional chemotherapy-based approach. In the present chapter we will address the achievements of conventional treatment with ATRA and chemotherapy, as well as the opportunity to cure more patients with modifications of this therapeutic backbone with the addition of ATO in any phase of treatment.

yearjournalcountryeditionlanguage
2014-06-08Best practiceresearch. Clinical haematology
10.1016/j.beha.2014.04.004https://pubmed.ncbi.nlm.nih.gov/24907015