Hematopoietic cell transplantation in acute promyelocytic leukemia: a comprehensive review.
The past three decades have brought major therapeutic advances in the management of acute promyelocytic leukemia. The current state-of-the-art induction treatment with all-trans retinoic acid in combination with anthracycline-based chemotherapy results in long-lasting remissions and cure in up to 70% of newly diagnosed patients. Unfortunately, treatment failure still occurs in one-third of patients. When disease relapses, patients can achieve subsequent remissions with arsenic trioxide, all-trans retinoic acid with or without chemotherapy, or other therapies. Patients achieving molecular remissions after salvage therapy are generally considered candidates for high-dose chemotherapy and autologous hematopoietic cell transplantation as a postconsolidation strategy. On the other hand, patients with evidence of persistent hematologic or molecular disease after salvage therapy could be offered allogeneic hematopoietic transplantation if a suitable HLA-donor is identified and the patient's overall performance and clinical condition are permissible. We hereby provide a comprehensive review and analysis of published clinical trials that evaluate the role of hematopoietic cell transplantation across different stages of acute promyelocytic leukemia.
Kharfan-Dabaja
Mohamed A
MA
Department of Interdisciplinary Oncology, H. Lee Moffitt Cancer Center and Research Institute and University of South Florida, Tampa 33612, USA, and Division of Hematology, Vancouver General Hospital, British Columbia, Canada. Kharfama@moffitt.usf.edu
Abou Mourad
Yasser R
YR
Fernandez
Hugo F
HF
Pasquini
Marcelo C
MC
Santos
Edgardo S
ES
D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis / Q000628:therapy*; D016879:Salvage Therapy / Q000379:methods; D017211:Treatment Failure