Update on the diagnosis of and therapy for acute promyelocytic leukemia and chronic myelogenous leukemia.
OBJECTIVE
To present information about recent Food and Drug Administration (FDA)-approved indications regarding drug therapy for acute promyelocytic leukemia (APL) and chronic myelogenous leukemia (CML) and about the nursing care of patients receiving these therapies and to review the significance of the use of polymerase chain reaction (PCR) assays in the management of patients with these leukemias.


METHODS
Published articles, book chapters, and production information.


RESULTS
Two agents with newly approved FDA indications are changing the focus of leukemia treatment from the cytotoxicity of specific drugs to the reversal of arrested maturation of myeloid cells. All-trans-retinoic acid (ATRA) induces remission in patients with relapsed or refractory APL. Interferon alfa (IFN-alpha) administered to patients with chronic-phase, Philadelphia-chromosome-positive CML produces improved survival rates and delays disease progression as compared to standard therapy. PCR assays are used with both of these diseases to confirm diagnosis, monitor response to these agents, and predict disease progression.


CONCLUSIONS
The care of patients with leukemia continues to change as new agents such as ATRA and are approved for treatment and new assays such as PCR become available for diagnosis and treatment monitoring.


CONCLUSIONS
The nursing care of patients with leukemia requires keeping knowledgeable about the latest information regarding the molecular biology of the disease, the mechanism of action of newly approved agents, and the clinical implications of developing tests. This knowledge allows nurses to assimilate new therapies into practice, which, in turn, enables them to help patients to understand and cope with treatment through patient education and innovative interventions for symptom management.
Wujcik
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Vanderbilt Cancer Center Affiliate Network, Nashville, TN, USA.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis / Q000188:drug therapy* / Q000451:nursing; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis / Q000188:drug therapy* / Q000451:nursing; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D009733:Nursing Diagnosis; D010348:Patient Care Team; D010353:Patient Education as Topic; D016133:Polymerase Chain Reaction
D000970:Antineoplastic Agents