title: Management of acute promyelocytic leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet.
abstract: The introduction of all-trans retinoic acid (ATRA) and, more recently, arsenic trioxide (ATO) into the therapy of acute promyelocytic leukemia (APL) has revolutionized the management and outcome of this disease. Several treatment strategies using these agents, usually in combination with chemotherapy, but also without or with minimal use of cytotoxic agents, have provided excellent therapeutic results. Cure of APL patients, however, is also dependent on peculiar aspects related to the management and supportive measures that are crucial to counteract life-threatening complications associated with the disease biology and molecularly targeted treatment. The European LeukemiaNet recently appointed an international panel of experts to develop evidence- and expert opinion-based guidelines on the diagnosis and management of APL. Together with providing current indications on genetic diagnosis, modern risk-adapted front-line therapy and salvage treatment, the review contains specific recommendations for the identification and management of most important complications such as the bleeding disorder, APL differentiation syndrome, QT prolongation and other ATRA- and ATO-related toxicities, as well as for molecular assessment of response to treatment. Finally, the approach to special situations is also discussed, including management of APL in children, elderly patients, and pregnant women.
authors.affiliation: University Hospital La Fe, Valencia, Spain. msanz@uv.es
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Sanz
authors.forename: David
authors.initials: D
authors.lastname: Grimwade
authors.forename: Martin S
authors.initials: MS
authors.lastname: Tallman
authors.forename: Bob
authors.initials: B
authors.lastname: Lowenberg
authors.forename: Pierre
authors.initials: P
authors.lastname: Fenaux
authors.forename: Elihu H
authors.initials: EH
authors.lastname: Estey
authors.forename: Tomoki
authors.initials: T
authors.lastname: Naoe
authors.forename: Eva
authors.initials: E
authors.lastname: Lengfelder
authors.forename: Thomas
authors.initials: T
authors.lastname: Büchner
authors.forename: Hartmut
authors.initials: H
authors.lastname: Döhner
authors.forename: Alan K
authors.initials: AK
authors.lastname: Burnett
authors.forename: Francesco
authors.initials: F
authors.lastname: Lo-Coco
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D016208:Databases, Factual; D005060:Europe; D005260:Female; D006287:Health Planning Guidelines; D018380:Hematopoietic Stem Cell Transplantation / Q000706:statistics & numerical data; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy; D012008:Recurrence; D012955:Societies, Medical; D014212:Tretinoin / Q000627:therapeutic use
chemical_list: D014212:Tretinoin