Use of all-trans retinoic acid to treat acute promyelocytic leukemia: a case with very severe features at the onset in Nicaragua.
We observed a child with acute promyelocytic leukemia (APL) who, at the onset, had extremely severe hemorrhagic and septic complications. According to our experience in Nicaragua, there was a very high risk of early death. The patient was successfully treated with a program that included all-trans retinoic acid (ATRA) followed by cytotoxic chemotherapy. ATRA has two important features: it is effective in initial treatment of APL and it is inexpensive. Because of the high cost and the need for extensive supportive care, optimal myeloablative therapy used in patients with various types of acute myeloid leukemia generally cannot be given in developing countries. ATRA treatment for APL is affordable everywhere.
Flores
A
A
Hospital Infantil Manuel de Jesús Rivera La Mascota, Managua, Nicaragua.
Malta
A
A
Pacheco
C
C
Baez
F
F
Ocampo
E
E
Conter
V
V
Masera
G
G
Biondi
A
A
Rovelli
A
A
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D016470:Bacteremia / Q000382:microbiology; D002648:Child; D003906:Developing Countries; D016527:Drug Costs; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D009527:Nicaragua; D011552:Pseudomonas Infections; D011550:Pseudomonas aeruginosa; D012074:Remission Induction; D017192:Skin Diseases, Bacterial / Q000209:etiology; D013207:Staphylococcal Skin Infections; D014212:Tretinoin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D014212:Tretinoin