Acute promyelocytic leukemia: What is the new standard of care?

Justin M. Watts, Martin S. Tallman

Research output: Contribution to journalReview article

46 Scopus citations

Abstract

Acute promyelocytic leukemia (APL) is one of the most exciting stories of modern medicine. Once a disease that was highly lethal, the majority of patients are now cured with the advent of molecularly targeted therapy with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). In many patients, chemotherapy can be omitted completely, particularly in patients with low- or intermediate-risk disease (white blood cell count. ≤. 10,000/μl). Recent data show overall survival exceeding 90% with ATRA and ATO-based induction and consolidation strategies. In the uncommon patient in whom relapse does occur, most can still be cured with ATO and autologous hematopoietic cell transplantation. Remaining challenges in APL management include the rapid identification and treatment of newly diagnosed patients to decrease the early death rate, optimizing treatment strategies in high-risk patients (white blood cell count. >. 10,000/μl), and the role of maintenance therapy in lower risk patients.

Original languageEnglish (US)
Pages (from-to)205-212
Number of pages8
JournalBlood Reviews
Volume28
Issue number5
DOIs
StatePublished - Sep 2014
Externally publishedYes

Keywords

  • Acute promyelocytic leukemia
  • All-trans retinoic acid (ATRA)
  • Arsenic trioxide (ATO)
  • Coagulopathy
  • Differentiation syndrome
  • Early death

ASJC Scopus subject areas

  • Hematology
  • Oncology

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