Differentiation therapy for acute promyelocytic leukemia with all-trans retinoic acid: 10-year experience of its clinical application.
OBJECTIVE
To summarize the experiences in using all-trans retinoic acid (ATRA) for the differentiation therapy for acute promyelocytic leukemia (APL) since our introduction of its use in clinic in 1986.


METHODS
Data resources came from Chinese Journal of Hematology, English-language literature using MEDLINE (1988-1998), book entitled "Treatment of Malignancies by Inducing Differentiation and Apoptosis" published by Shanghai Publishing House on Sciences and Technology, and our recent data to be published.


METHODS
Thirty-five articles related to the purpose of this review were reviewed.


METHODS
Data were checked for their quality, reliance and originality.


RESULTS
ATRA combined with chemotherapy can decrease the incidence of retinoic acid syndrome and produce a very high remission rate (90%-95%). Post-remission treatment should include chemotherapy and ATRA, the 5-year survival probability was able to attain 0.71 +/- 0.06. The main problem in the treatment is early tolerance to ATRA and relapse of the disease. The most effective treatments for relapsed APL is to use arsenic trioxide.


CONCLUSIONS
The combination of ATRA, chemotherapy and arsenic oxide in the treatment of APL for elevating the remission rate and prolonging survival time deserves further study.
Wang
Z
Z
Shanghai Institute of Hematology, Rui-Jin Hospital, Shanghai Second Medical University, Shanghai 200025, China.
Sun
G
G
Shen
Z
Z
Chen
S
S
Chen
Z
Z
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002454:Cell Differentiation / Q000187:drug effects; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000473:pathology; D012074:Remission Induction; D015996:Survival Rate; D014212:Tretinoin / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D014212:Tretinoin