Current management of newly diagnosed acute promyelocytic leukemia

L. Cicconi, Francesco Lo-Coco

Research output: Contribution to journalReview article

Abstract

The management of acute promyelocytic leukemia (APL) has considerably evolved during the past two decades. The advent of all-trans retinoic acid (ATRA) and its inclusion in combinatorial regimens with anthracycline chemotherapy has provided cure rates exceeding 80%; however, this widely adopted approach also conveys significant toxicity including severe myelosuppression and rare occurrence of secondary leukemias. More recently, the advent of arsenic trioxide (ATO) and its use in association with ATRA with or without chemotherapy has further improved patient outcome by allowing to minimize the intensity of chemotherapy, thus reducing serious toxicity while maintaining high anti-leukemic efficacy. The advantage of ATRA-ATO over ATRA chemotherapy has been recently demonstrated in two large randomized trials and this option has now become the new standard of care in low-risk (i.e. non-hyperleukocytic) patients. In light of its rarity, abrupt onset and high risk of early death and due to specific treatment requirements, APL remains a challenging condition that needs to be managed in highly experienced centers. We review here the results of large clinical studies conducted in newly diagnosed APL as well as the recommendations for appropriate diagnosis, prevention and management of the main complications associated with modern treatment of the disease.

Original languageEnglish
Pages (from-to)1474-1481
Number of pages8
JournalAnnals of Oncology
Volume27
Issue number8
DOIs
Publication statusPublished - Aug 1 2016

Keywords

  • Acute promyelocytic leukemia
  • All-trans retinoic acid
  • Arsenic trioxide
  • PML-RARA

ASJC Scopus subject areas

  • Medicine(all)
  • Hematology
  • Oncology

Fingerprint Dive into the research topics of 'Current management of newly diagnosed acute promyelocytic leukemia'. Together they form a unique fingerprint.

  • Cite this