ACTA FAC MED NAISS 2014;31(1):17-28

Review article

UDC:616.155.392-08

DOI:10.2478/afmnai-2014-0002

New Frontiers of Target Therapy in Oncology: Acute Promyelocytic Leukemia

Ivan Petković¹, Ivica Pejčić^1,2, Svetislav Vrbić^1,2

¹Oncology Clinic, Clinical Center Niš, Serbia

²University of Niš, Faculty of Medicine, Serbia


summary

By introduction of all-trans retinoic acid (ATRA) in de novo acute promyelocytic leukemia (APL) an revolution in therapy of this disease has been made. The rate of molecular complete remissions (CR) have been doubled compared to conventional chemotherapy with anthracyclines ranging from 90% to 95%. Consolidation therapy is required in order to reduce the risk of early relapse. Maintenance therapy is recommended as it further reduces the risk of relapse, especially in high-risk patients. The relapse rate in APL is relatively high, about 30% and is the most common within three years of starting the treatment. Another agent, arsenic trioxide (ATO) is the optimal drug that achieves high CR rate in relapsed, approximately 80% and hematopoietic stem cell transplantation (HSCT) may prolong the overall survival in patients with APL. ATRA and ATO have become a paradigm of targeted therapy, and APL is a paradigm of curable disease, at least in comparison to other forms of acute myeloid leukemia (AML).

Key words: acute promyelocytic leukemia, target therapy