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Annals of Hematology
Published in: Annals of Hematology 12/2022

16-08-2022 | Acute Promyelocytic Leukemia | Review Article

Treatment for relapsed acute promyelocytic leukemia

Author: Masamitsu Yanada

Published in: Annals of Hematology | Issue 12/2022

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Abstract

The advent of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) has significantly improved the outcomes of acute promyelocytic leukemia (APL); nevertheless, a small fraction of patients still experience relapse. Due to the infrequency of APL relapse coupled with the rapid change in the therapeutic landscape, there are limited available data regarding the treatment of relapsed APL. In this situation, however, ATO-based therapy has been shown to result in high rates of hematological and molecular complete remission (CR). Autologous hematopoietic cell transplantation (HCT) is considered the postremission therapy of choice when patients achieve molecular CR, whereas recent studies have suggested that molecular CR is not prerequisite for the success of autologous HCT. Allogeneic HCT can be reserved for selected patients, i.e., those who cannot achieve CR and those who relapse after autologous HCT, because of high toxicities and the expectation of highly favorable outcomes with autologous HCT during CR. For patients who are ineligible for HCT, prolonged administration of ATRA + ATO would be a viable option. To further refine the therapy for patients with relapsed APL, it is imperative to aggregate clinical data of patients who relapse after the ATRA + ATO frontline therapy within the framework of national and international collaboration.
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Metadata
Title
Treatment for relapsed acute promyelocytic leukemia
Author
Masamitsu Yanada
Publication date
16-08-2022
Publisher
Springer Berlin Heidelberg
Published in
Annals of Hematology / Issue 12/2022
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-022-04954-0

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