because several clinical trials have shown contradictory results. Minimal residual disease (MRD) can be evaluated in patients with APL through polymerase chain reaction (PCR) analysis of the PML/RARα fusion gene product. In fewer than 2% of patients with
Chezi Ganzel, Dan Douer and Martin S. Tallman
Olga Frankfurt and Martin S. Tallman
The outcome of acute promyelocytic leukemia (APL) has improved dramatically during the past 40 years. Insights into the genetic and biologic mechanisms of APL lead to the development of specific and effective therapeutic strategies. This article discusses the therapeutic interventions that transformed APL from one of the most lethal leukemias to one that is highly curable.
Thomas Prebet and Steven D. Gore
Acute promyelocytic leukemia (APL) represents a remarkable disease in which leukemogenesis is driven by the PML-RARα oncogene and for which targeted treatment with all-trans retinoic acid (ATRA)–based therapy allows substantial chance of cure. APL is seen in a small subset of older patients, with age representing one of the most important prognostic factors for outcome of treatment. Unlike other acute leukemias, the inferior outcomes for APL in older patients relates less to changes in disease biology and more to the increased toxicity of ATRA and the chemotherapy combination regimens used to induce hematologic and molecular responses. Risk-adapted strategies that use less-toxic agents, such as arsenic trioxide, allow treatment of older patients, with greater efficiency and better chances of cure.
Guru Subramanian Guru Murthy, Aniko Szabo, Laura Michaelis, Karen-Sue Carlson, Lyndsey Runaas, Sameem Abedin and Ehab Atallah
. Douer D , Santillana S , Ramezani L , . Acute promyelocytic leukaemia in patients originating in Latin America is associated with an increased frequency of the BCR1 subtype of the PML/RARα fusion gene . Br J Haematol 2003 ; 122 : 563 – 570