Acute promyelocytic leukemia: preventing early complications and late toxicities

S. Abedin, J. K. Altman
2016 Hematology ASH Education Program  
Acute promyelocytic leukemia (APL) is a unique subtype of acute myeloid leukemia (AML), which presents with a distinct coagulopathy. Therapeutic advances have made APL one of the true success stories in oncology, transforming this once lethal disease into the most curable form of AML. For many patients, cure will now be achieved without the use of chemotherapy. It is hoped that limiting chemotherapy will reduce mortality even further, particularly among more vulnerable older adults whose
more » ... adults whose survival lagged behind that of younger patients. It should be noted that early death persists in patients with APL and continues to negatively affect survival. Further, among survivors treated with chemotherapy or even arsenic trioxide (ATO), there remains the potential for long-term toxicities that must be monitored. Understanding the management of these issues is an important complement to ensure maximal survival for patients with APL. Learning Objectives • APL is a highly curable malignancy; however, early and late complications exist • Administration of all-trans retinoic acid at first suspicion of APL and appropriate transfusion support are recommended to minimize early hemorrhagic complications • Toxicities in the ATO era are different, and vigilant monitoring for late complications after APL therapy is needed Correspondence
doi:10.1182/asheducation-2016.1.10 pmid:27913456 fatcat:pf77u2b2ava3rheoahy442toge