title: Extramedullary disease in APL: a real phenomenon to contend with or not?
abstract: In the last 2 decades an increasing number of patients reported with extramedullary involvement among relapsed acute promyelocytic leukemia (APL) patients. Several investigators related this phenomenon to the relatively new treatment of all-trans-retinoic-acid (ATRA). In this review article we will examine what has been reported in the medical literature on extramedullary disease in APL: the common sites to be involved, the clinical risk factors to its development, the role of ATRA and arsenic tri-oxide and the recommended treatment.
authors.affiliation: Shaare Zedek Medical Center, Jerusalem, Israel; Leukemia Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA. Electronic address: ganzelct@yahoo.com.
authors.forename: Chezi
authors.initials: C
authors.lastname: Ganzel
authors.affiliation: Leukemia Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; Weil Cornell Medical College, NYC, USA. Electronic address: douerd@mskcc.org.
authors.forename: Dan
authors.initials: D
authors.lastname: Douer
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000008:administration & dosage; D001565:Benzoates / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy / Q000473:pathology*; D017254:Leukemic Infiltration / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D008954:Models, Biological; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D009928:Organ Specificity; D010087:Oxides / Q000008:administration & dosage; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012074:Remission Induction; D012307:Risk Factors; D013764:Tetrahydronaphthalenes / Q000627:therapeutic use; D014212:Tretinoin / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology
chemical_list: D001152:Arsenicals; D001565:Benzoates; D010087:Oxides; D013764:Tetrahydronaphthalenes; C061133:tamibarotene; D014212:Tretinoin; D000077237:Arsenic Trioxide
keywords: APL; CNS relapse; acute promyelocytic leukemia; extramedullary disease