Differentiating agents in pediatric malignancies: All-trans-retinoic acid and arsenic in acute promyelocytic leukemia

被引:20
作者
Calleja E.M. [1 ]
Warrell R.P. [2 ]
Jr [2 ]
机构
[1] Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, 10021
[2] Genta Incorporated, Berkeley Heights, NJ, 07922
关键词
Arsenic; Acute Myeloid Leukemia; Retinoic Acid; Acute Promyelocytic Leukemia; Arsenic Trioxide;
D O I
10.1007/s11912-000-0105-x
中图分类号
学科分类号
摘要
Acute promyelocytic leukemia (APL) is the most potentially curable type of acute myeloid leukemia. It is characterized by the chromosomal translocation t(15;17), which results in the fusion gene PML-RAR-alpha. The introduction of all-trans- retinoic acid (ATRA) was a major advance in treatment of this disease. This agent induces terminal differentiation of malignant myeloid cells to mature neutrophils, and its side effects are usually well tolerated in children. ATRA does not eradicate the malignant myeloid clone in APL and, eventually, resistance develops. Arsenic trioxide induces nonterminal differentiation of malignant promyelocytes and promotes apoptosis. APL patients treated with ATRA or arsenic trioxide have rapid resolution of their coagulopathy. Because both of these drugs are well tolerated in children and their synergy has been shown in animal models, the possibility of combining ATRA and arsenic trioxide in front-line therapy for children with APL is being considered.
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页码:519 / 523
页数:4
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