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Update on acute promyelocytic leukemia in the pediatric population


Hematology & Transfusion International Journal
Ruiz-Rodríguez Adriana, Obando-Madrigal Lucía, Mateus-Vargas, Ana Lucía

Abstract

Acute promyelocytic leukemia (APL) has shown differences in incidence around the world, it has a characteristic molecular, pathogenic and clinical development mechanism. Despite being a low incidence acute myeloid leukemia (AML) compared to other AML and having a good response to therapy, it continues to be of interest due to the toxicities of its current treatment, to mutations that have shown resistance to those drugs, and to the few possibilities of alternative treatment with all-trans retinoic acid (ATRA) and anthracyclines in the pediatric population. Furthermore, the description of new mutations produced by LPA generates new interest in studies that may shed light on their effects on the disease’s incidence, prognoses, and response to treatment. This article aims to review different studies that describe findings of APL in terms of incidences, treatments, side effects, survival, especially in the pediatric population. Different studies propose the use of ATRA - arsenic trioxide (ATO) as the first line of treatment, however, few have been carried out in the pediatric population and the use of ATO is not recommended in children under 5 years of age. On the other hand, the differentiation syndrome (DS) has been described, which occurs in patients treated with ATRA, and requires careful monitoring and control.

Keywords

pediatric leukemias, acute promyelocytic leukemia, differentiation syndrome, arsenic trioxide, anthracyclines, all-trans retinoic acid

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