Management of Acute Promyelocytic Leukemia at Extremes of Age

Tailored treatment with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) has revolutionized the outcome of acute promyelocytic leukemia (APL) from a uniformly fatal disease to one of the most curable malignant diseases in humans. Due to its high efficacy, ATO/ATRA is the standard first-line...

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Bibliographic Details
Published in:Cancers 2023-07, Vol.15 (14), p.3637
Main Authors: Kayser, Sabine, Conneely, Shannon E
Format: Article
Language:English
Subjects:
Acute promyeloid leukemia
Age
Arsenic
Arsenic trioxide
Case reports
Children
Cohort analysis
Epidemiology
Health aspects
Leukemia
Medical research
Medicine, Experimental
Mortality
Patients
Pediatrics
Promyeloid leukemia
Retinoic acid
Review
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Summary:Tailored treatment with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) has revolutionized the outcome of acute promyelocytic leukemia (APL) from a uniformly fatal disease to one of the most curable malignant diseases in humans. Due to its high efficacy, ATO/ATRA is the standard first-line therapy in younger adult, non-high-risk APL patients. However, early death is still a major issue in APL, particularly in older patients. Thus, rapid diagnostics, immediate access to ATRA-based therapy, and supportive care are of utmost importance. Nevertheless, challenging situations occur, particularly in patients excluded from controlled studies with clinical knowledge mainly based on case reports and registries. Besides the treatment of newly diagnosed patients, managing toxicities and complications remains challenging. This review discusses the approach to the treatment of APL in elderly and pediatric patients.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers15143637