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Risk factors and remaining challenges in the treatment of acute promyelocytic leukemia

  • Progress in Hematology
  • Acute myeloid Leukemia: Recent progress in AML with recurrent genetic abnormalities and Molecular targeted therapy
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Abstract

The treatment of acute promyelocytic leukemia (APL) has evolved with the introduction of all-trans retinoic acid (ATRA) and subsequent arsenic trioxide (ATO), particularly in standard-risk APL with an initial white blood cell count (WBC) < 10,000/μL, where a high cure rate can now be achieved. However, for some patients with risk factors, early death or relapse remains a concern. Insights from the analysis of patients treated with ATRA and chemotherapy have identified risk factors such as WBC, surface antigens, complex karyotypes, FLT3 and other genetic mutations, p73 isoforms, variant rearrangements, and drug resistance mutations. However, in the ATRA + ATO era, the significance of these risk factors is changing. This article provides a comprehensive review of APL risk factors, taking into account the treatment approach, and explores the challenges associated with APL treatments.

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Japan Agency for Medical Research and Development, 23ck0106715h0003, Yasuhisa Yokoyama.

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  1. Department of Hematology, University of Tsukuba, Tsukuba, Ibaraki, Japan

    Yasuhisa Yokoyama

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Yokoyama, Y. Risk factors and remaining challenges in the treatment of acute promyelocytic leukemia. Int J Hematol (2024). https://doi.org/10.1007/s12185-023-03696-7

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