Advances in therapies for acute promyelocytic leukemia

Tomohiko Kamimura, Toshihiro Miyamoto, Mine Harada, Koichi Akashi

Research output: Contribution to journalReview article

36 Citations (Scopus)

Abstract

Acute promyelocytic leukemia (APL), a distinct subtype of acute myelogenous leukemia (AML), results from the arrest of the maturation of hematopoietic progenitors at the promyelocyte stage. It has been shown that APL is associated with a reciprocal chromosomal translocation, involving chromosomes 15 and 17, which fuses the gene encoding the retinoic acid receptor α (RARα) and the promyelocytic leukemia (PML) gene. The resultant PML-RARα fusion protein plays a critical role in the pathogenesis of APL. Although there are many subtypes of AML, all are typically managed using a standard chemotherapy regimen of an anthracycline plus cytarabine arabinoside (CA). Despite high rates of complete remission following standard chemotherapy, most patients relapse and long-term disease-free survival is only 30-40%. The introduction of drugs such as all-trans retinoic acid (ATRA) that promote progenitor differentiation by directly inhibiting the PML-RARα fusion protein has changed the treatment paradigm for APL and markedly improved patient survival. The purposes of the present review are to provide the latest results and future directions of clinical research into APL and to illustrate how new therapies, such as ATRA plus anthracycline-based induction and consolidation therapy, risk-adapted therapy, salvage therapy containing arsenic trioxide-based regimens, and hematopoietic stem cell transplantation, have improved the treatment outcomes for APL patients.

Original languageEnglish
Pages (from-to)1929-1937
Number of pages9
JournalCancer Science
Volume102
Issue number11
DOIs
Publication statusPublished - Nov 1 2011

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Acute Promyelocytic Leukemia
Retinoic Acid Receptors
Leukemia
Anthracyclines
Tretinoin
Acute Myeloid Leukemia
Therapeutics
Chromosomes, Human, Pair 15
Drug Therapy
Granulocyte Precursor Cells
Salvage Therapy
Genetic Translocation
Chromosomes, Human, Pair 17
Hematopoietic Stem Cell Transplantation
Cytarabine
Genes
Disease-Free Survival
Proteins
Recurrence
Survival

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Advances in therapies for acute promyelocytic leukemia. / Kamimura, Tomohiko; Miyamoto, Toshihiro; Harada, Mine; Akashi, Koichi.

In: Cancer Science, Vol. 102, No. 11, 01.11.2011, p. 1929-1937.

Research output: Contribution to journalReview article

Kamimura, Tomohiko ; Miyamoto, Toshihiro ; Harada, Mine ; Akashi, Koichi. / Advances in therapies for acute promyelocytic leukemia. In: Cancer Science. 2011 ; Vol. 102, No. 11. pp. 1929-1937.
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