Abstract：
:Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia (AML) characterized by a specific genetic alteration, affecting the retinoic acid receptor-alpha (RARalpha), and leading to a blockage in the differentiation of the granulocytic cells. The accumulation of the promyelocytic blasts in the bone marrow produces intense peripheral blood cytopenias or, less commonly, hyperleucocytosis, both of which are frequently associated with a life-threatening consumptive coagulopathy. The body of available biological information on APL establishes this leukemia as a unique entity that has to be promptly recognized and clearly distinguished from all other acute leukemias, especially in light of its striking response to treatment with anthracyclines and differentiating agents such as all-trans retinoic acid (ATRA) or arsenic trioxide (ATO). Current state-of-the-art treatments, which include simultaneous administration of ATRA and anthracycline-based chemotherapy for induction and consolidation, as well as ATRA-based maintenance, have dramatically transformed APL into the most curable acute leukemia in adults, with approximately 80% of long-term survivors. Risk-adapted strategies to modulate treatment intensity may be an effective approach to minimizing therapy-related morbidity and mortality while maintaining the potential of cure. Nonetheless, a sizeable proportion of patients will relapse after the ATRA-based upfront therapy. Given the high anti-leukemic efficacy observed with ATO in patients who relapse, this agent is currently regarded as the best treatment option in this setting. In this article, we will review the current treatment strategies in the management of newly diagnosed and relapsed APL. We also highlight other aspects that can be crucial for the outcome of individual patients, including supportive care, recognition and treatment of life-threatening complications, management of ATRA- and ATO-associated adverse events, and the role of minimal residual disease (MRD) monitoring.
journal_name
Semin Oncoljournal_title
Seminars in oncologyauthors
Lo-Coco F,Ammatuna E,Montesinos P,Sanz MAdoi
10.1053/j.seminoncol.2008.04.010subject
Has Abstractpub_date
2008-08-01 00:00:00pages
401-9issue
4eissn
0093-7754issn
1532-8708pii
S0093-7754(08)00120-6journal_volume
35pub_type
杂志文章abstract：:It has been a challenge to find effective chemotherapeutic treatments for malignant mesothelioma. Over the last several decades numerous single-drug and combination regimens have been examined, but no standard treatment with chemotherapy alone has emerged. Possible explanations for this lack of success are the heterog...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/sonc.2002.30231
更新日期：2002-02-01 00:00:00
abstract：:The curative management of gastric adenocarcinoma depends on complete resection of the primary tumor. In patients with lymph node metastases in the resected specimen, the relapse and death rates from recurrent cancer are 70% to 80%. There is continued debate over whether more extensive lymph node dissection (D2) impro...
journal_title：Seminars in oncology
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doi：10.1016/s0093-7754(03)00298-7
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journal_title：Seminars in oncology
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journal_title：Seminars in oncology
pub_type： 临床试验,杂志文章,评审
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：2000-06-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1994-10-01 00:00:00
abstract：:Combination antimicrotubule therapy with estramustine phosphate (EMP) and vinblastine has reproducible activity in metastatic hormone-refractory prostate cancer (HRPC) with an objective response rate of 31%. Although paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) by 24-hour infusion was inactive in HR...
journal_title：Seminars in oncology
pub_type： 临床试验,杂志文章
doi：
更新日期：1995-10-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2005.04.022
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1990-04-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1995-08-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2014.02.002
更新日期：2014-04-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 杂志文章
doi：10.1053/j.seminoncol.2015.05.004
更新日期：2015-08-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：2001-06-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1998-08-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2012.08.006
更新日期：2012-10-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1998-04-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1992-02-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 杂志文章
doi：10.1053/j.seminoncol.2007.01.002
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1996-02-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1996-08-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
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更新日期：2004-02-01 00:00:00
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journal_title：Seminars in oncology
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
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journal_title：Seminars in oncology
pub_type： 杂志文章
doi：
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journal_title：Seminars in oncology
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1992-04-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 杂志文章
doi：10.1053/j.seminoncol.2004.11.017
更新日期：2005-04-01 00:00:00
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journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2005.02.009
更新日期：2005-06-01 00:00:00
