[Leukemogenesis and therapy of acute promyelocytic leukemia: from the worse to the most favorable subtype of acute myeloid leukemia].
The evolution of therapy of acute promyelocytic leukemia (APL) from 1964 to present is reviewed. The paper is focused on the main findings and key studies which formed current and almost standard therapeutic approach to APL. The first important development was the use of anthracyclines for the initial therapy of APL in 1967. Starting 1972, heparin was introduced into a treatment of coagulopathy and the intensity of substitutional transfusion therapy was remarkably enhanced. The main breakthrough was the initiation of differentiation therapy using all-trans retinoic acid (ATRA). The first clinical study which brought information about the effect of ATRA in APL started in China in 1986. A number of the most important subsequent studies focused on pathogenesis and therapy of APL are analyzed and reviewed. The additional considerable finding was the discovery of arsenic trioxide (ATO) therapeutic efficacy in APL and ATO is now in particular used for a therapy of relapsed APL. The publication gives also a recent insight into a leukemogenesis of APL and development of a resistance to ATRA. At the conclusion, the authors emphasize the need of early diagnosis as a one of the main conditions for successful treatment of APL.
Korístek
Z
Z
Interní hematoonkologická klinika Lékarské Fakulty MU a FN Brno. Zdenek.Koristek@seznam.cz
Mayer
J
J
D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology