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

Autores de IIS La Fe

• Miguel Ángel Sanz Alonso

  Autor

• Gloria Iacoboni Garcia-Calvo

  Autor

• Pau Montesinos Fernández

  Autor

Grupos

• Hematología y Hemoterapia

Abstract

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 (C) 2014 Elsevier Ltd. All rights reserved.

Keywords

• acute promyelocytic leukemia; all-trans retinoic acid; anthracycline; arsenic trioxide; chemotherapy; targeted therapy