Contemporary Treatment of APL
Contemporary Treatment of APL
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DOI：
10.1007/s11899-014-0205-6
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发表时间：
2014-06-01
影响因子：
2.9
通讯作者：
Altman, Jessica K.
中科院分区：
文献类型：
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作者：
Cull, Elizabeth H.;Altman, Jessica K.
急性早幼粒细胞白血病(APL)以凝血障碍、白细胞减少和对蒽环类药物、全反式维甲酸(ATRA)和三氧化二砷(ATO)敏感为特征。在过去的25年里，APL一直采用全反式维甲酸和化疗相结合的方法进行诱导，然后进行巩固和维持治疗。这种综合治疗方法的治愈率达到了80%-90%。ATO最初被批准用于复发性APL，现已被纳入当代的前期治疗方案，具有极好的应答率。最近的研究表明，大多数APL患者可以单独使用全反式维甲酸和全反式维甲酸治愈，消除了细胞毒性化疗，并产生了比标准治疗更好的结果。在这里，我们将回顾APL的历史治疗，在特定患者群体中的治疗考虑，以及治疗的最新进展。
Acute promyelocytic leukemia (APL) is characterized by coagulopathy, leukopenic presentation and sensitivity to anthracyclines, all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). For the last 25 years, APL has been treated with a combination of ATRA and chemotherapy for induction followed by consolidation and maintenance therapy. This general treatment approach has resulted in cure rates of 80-90 %. ATO, originally approved in relapsed APL, has been incorporated into contemporary upfront treatment regimens with excellent response rates. Recent studies show that most patients with APL can be cured with ATRA and ATO alone, eliminating cytotoxic chemotherapy and resulting in superior outcomes compared to standard treatment. We will herein review historical treatment of APL, treatment considerations in specific patient populations, and therapeutic updates.