title: All-trans retinoic acid in the treatment of pediatric acute promyelocytic leukemia.
abstract: Acute promyelocytic leukemia (APL) is a rare form of acute myeloid leukemia with specific epidemiological, pathogenetic and clinical features. Its frequency varies widely among nations, with a decreased incidence among 'Nordic' origin populations. The molecular hallmark of the disease is the presence of a balanced reciprocal translocation resulting in the PML/RAR-α gene fusion, which represents the target of the all-trans retinoic acid (ATRA) therapy. The introduction of ATRA in conjunction with anthracyclines marked a turning point in the treatment of APL, previously associated with a significant morbidity and mortality. Nowadays the standard front-line therapy for pediatric APL includes ATRA in every phase of the treatment, resulting in a complete remission rate of 90-95%. Here we provide an overview of the role of ATRA in the treatment of pediatric APL, summarizing the most relevant clinical results of recent decades and investigating future therapeutic perspectives for children with APL.
authors.affiliation: Paediatric Oncology and Haematology Unit 'Lalla Seràgnoli', University of Bologna Sant'Orsola-Malpighi Hospital, Bologna, Italy. riccardo.masetti@gmail.com
authors.forename: Riccardo
authors.initials: R
authors.lastname: Masetti
authors.forename: Francesca
authors.initials: F
authors.lastname: Vendemini
authors.forename: Daniele
authors.initials: D
authors.lastname: Zama
authors.forename: Carlotta
authors.initials: C
authors.lastname: Biagi
authors.forename: Pietro
authors.initials: P
authors.lastname: Gasperini
authors.forename: Andrea
authors.initials: A
authors.lastname: Pession
mesh_terms: D018943:Anthracyclines / Q000627:therapeutic use*; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D002648:Child; D002986:Clinical Trials as Topic; D060830:Consolidation Chemotherapy / Q000379:methods; D018572:Disease-Free Survival; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy / Q000235:genetics / Q000378:metabolism; D060046:Maintenance Chemotherapy / Q000379:methods; D058990:Molecular Targeted Therapy / Q000379:methods; D015514:Oncogene Proteins, Fusion / Q000235:genetics*; D011559:Pseudotumor Cerebri / Q000139:chemically induced; D012074:Remission Induction / Q000379:methods*; D014178:Translocation, Genetic / Q000187:drug effects; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics
chemical_list: D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D015514:Oncogene Proteins, Fusion; C093476:promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein; D014212:Tretinoin