ACUTE PROMYELOCYTIC LEUKEMIA (APL): COMPARISON BETWEEN CHILDREN AND ADULTS
Open Access
- 2 January 2014
- journal article
- review article
- Published by Hematology Section, Dept. of Radiological Science and Hematology, Catholic University, Rome, Italy in Mediterranean Journal of Hematology and Infectious Diseases
- Vol. 6 (1), e2014032
- https://doi.org/10.4084/mjhid.2014.032
Abstract
The outcome of adults and children with Acute Promyelocytic Leukemia (APL) has dramatically changed since the introduction of all trans retinoic acid (ATRA) therapy. Based on the results of several multicenter trials, the current recommendations for the treatment of patients with APL include ATRA and anthracycline-based chemotherapy for the induction of remission and for consolidation, and ATRA combined with low-dose chemotherapy for maintenance. This has improved the prognosis of APL by increasing the complete remission (CR) rate, actually > 90%, decreasing the induction deaths and by reducing the relapse rate, leading to cure rates nowadays exceeding 80% considering both adults and children1-9. More recently the combination of ATRA and arsenic trioxide (ATO) as induction and consolidation therapy has been shown to be at least not inferior and possibly superior to ATRA plus chemotherapy in adult patients with APL conventionally defined as non-high risk (Sanz score)10. Childhood APL has customarily been treated on adult protocols. Data from several trials have shown that the overall outcome in pediatric APL appears similar to that reported for the adult population, however some clinical and therapeutic aspects differ in the two cohorts which require some important considerations and treatment adjustments.Keywords
This publication has 66 references indexed in Scilit:
- Outcome of Acute Promyelocytic Leukemia (APL) in Children and Adolescents: An Analysis in Two Consecutive Trials of the European APL GroupJournal of Clinical Oncology, 2012
- EPIDEMIOLOGY, DIAGNOSIS AND TREATMENT OF ACUTE PROMYELOCYTIC LEUKEMIA IN CHILDREN: THE EXPERIENCE IN CHINAMediterranean Journal of Hematology and Infectious Diseases, 2012
- Increased BMI correlates with higher risk of disease relapse and differentiation syndrome in patients with acute promyelocytic leukemia treated with the AIDA protocolsBlood, 2012
- Continuing high early death rate in acute promyelocytic leukemia: a population-based report from the Swedish Adult Acute Leukemia RegistryLeukemia, 2011
- HISTORY OF ACUTE PROMYELOCYTIC LEUKEMIA: A TALE OF ENDLESS REVOLUTIONMediterranean Journal of Hematology and Infectious Diseases, 2011
- HOW I TREAT NEWLY DIAGNOSED ACUTE PROMYELOCYTIC LEUKEMIAMediterranean Journal of Hematology and Infectious Diseases, 2011
- Treatment of children with acute promyelocytic leukemia: Results of the first North American intergroup trial INT0129Pediatric Blood & Cancer, 2009
- Central nervous system involvement at first relapse in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline monochemotherapy without intrathecal prophylaxisHaematologica, 2009
- Hematopoietic Stem Cell Transplant for Pediatric Acute Promyelocytic LeukemiaTransplantation and Cellular Therapy, 2008
- Management of APL in Developing Countries: Epidemiology, Challenges and Opportunities for International CollaborationHematology, 2006