title: Conventional induction and post-remission therapy in APL: have we arrived?
abstract: Since the introduction of all-trans-retinoic acid, the use of this molecularly targeted treatment in combination with anthracycline-based chemotherapy has completely changed the prognosis of acute promyelocytic leukemia (APL) turning it into the most curable acute myeloid leukemia. Also, the use of risk-adapted protocols has optimized the drug combination and the most appropriate dose intensity for each subset of patients classified according to both risk of relapse and vulnerability to drug toxicity. Recent developments have included the investigation of the role of arsenic trioxide (ATO) as front-line treatment after its success in relapsed APL, both to minimize or even omit the use of cytotoxic agents and to reinforce the conventional chemotherapy-based approach. In the present chapter we will address the achievements of conventional treatment with ATRA and chemotherapy, as well as the opportunity to cure more patients with modifications of this therapeutic backbone with the addition of ATO in any phase of treatment.
authors.affiliation: Hospital Universitario La Fe and Department of Medicine of the Universitat de Valencia, Valencia, Spain. Electronic address: msanz@uv.es.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Sanz
authors.affiliation: Hospital Universitario La Fe and Department of Medicine of the Universitat de Valencia, Valencia, Spain.
authors.forename: Gloria
authors.initials: G
authors.lastname: Iacoboni
authors.affiliation: Hospital Universitario La Fe and Department of Medicine of the Universitat de Valencia, Valencia, Spain.
authors.forename: Pau
authors.initials: P
authors.lastname: Montesinos
mesh_terms: D018943:Anthracyclines / Q000008:administration & dosage / Q000494:pharmacology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D060830:Consolidation Chemotherapy; D003630:Daunorubicin / Q000008:administration & dosage; D006248:Harringtonines / Q000008:administration & dosage; D000077863:Homoharringtonine; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D060046:Maintenance Chemotherapy; D015122:Mercaptopurine / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D008942:Mitoxantrone / Q000008:administration & dosage; D015337:Multicenter Studies as Topic; D010087:Oxides / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D012074:Remission Induction; D014212:Tretinoin / Q000008:administration & dosage / Q000494:pharmacology
chemical_list: D018943:Anthracyclines; D001152:Arsenicals; D006248:Harringtonines; D010087:Oxides; D014212:Tretinoin; D000077863:Homoharringtonine; D008942:Mitoxantrone; D015122:Mercaptopurine; D000077237:Arsenic Trioxide; D008727:Methotrexate; D015255:Idarubicin; D003630:Daunorubicin
keywords: acute promyelocytic leukemia; all-trans retinoic acid; anthracycline; arsenic trioxide; chemotherapy; targeted therapy