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Acta Facultatis Medicae Naissensis

The Journal of Faculty of Medicine in Nis

4 Issues per year


Cite Score 2016: 0.25

SCImago Journal Rank (SJR) 2015: 0.109
Source Normalized Impact per Paper (SNIP) 2015: 0.124

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2217-2521
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New frontiers of target therapy in oncology: acute promyelocytic leukemia

Ivan Petković / Ivica Pejčić / Svetislav Vrbić
Published Online: 2014-03-25 | DOI: https://doi.org/10.2478/afmnai-2014-0002

SUMMARY

By introduction of all-trans retinoic acid (ATRA) in de novo acute promyelocytic leukemia (APL) an revolution in therapy of this disease has been made. The rate of molecular complete remissions (CR) have been doubled compared to conventional chemotherapy with anthracyclines ranging from 90% to 95%. Consolidation therapy is required in order to reduce the risk of early relapse. Maintenance therapy is recommended as it further reduces the risk of relapse, especially in high-risk patients. The relapse rate in APL is relatively high, about 30% and is the most common within three years of starting the treatment. Another agent, arsenic trioxide (ATO) is the optimal drug that achieves high CR rate in relapsed, approximately 80% and hematopoietic stem cell transplantation (HSCT) may prolong the overall survival in patients with APL. ATRA and ATO have become a paradigm of targeted therapy, and APL is a paradigm of curable disease, at least in comparison to other forms of acute myeloid leukemia (AML).

Sažetak

Uvođenjem all-trans retinoične kiseline (ATRA) u de novo akutnoj promijelocitnoj leukemiji (APL) napravljena je revolucija u terapiji ove bolesti. Stopa molekularnih kompletnih remisija (CR) udvostručila se u odnosu na konvencionalnu hemioterapiju antraciklinima i kreće se 90-95%. Konsolidaciona terapija je obavezna radi redukcije rizika od ranog relapsa bolesti. Terapija održavanja je preporučena jer dodatno redukuje rizik od relapsa, pogotovo kod visoko rizičnih bolesnika. Stopa relapsa APL je relativno visoka, oko 30%, i najčešća je unutar tri godine od početka lečenja. Drugi agens, arsen trioksid (ATO) je optimalni medikament koji postiže visoke stope CR u relapsu, oko 80%, a transplantacija matičnih ćelija hematopoeze (TMĆH) može produžiti ukupno preživljavanje bolesnika sa APL. ATRA i ATO su postali paradigma target terapije, a APL paradigma kurabilne maligne bolesti, bar u odnosu na druge forme akutnih mijeloidnih leukemija (AML).

Keywords: acute promyelocytic leukemia; target therapy

Ključne reči: akutna promijelocitna leukemija; ciljana terapija

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About the article

Published Online: 2014-03-25

Published in Print: 2014-03-01


Citation Information: Acta Facultatis Medicae Naissensis, ISSN (Print) 2217-2521, DOI: https://doi.org/10.2478/afmnai-2014-0002.

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  • I like my work, even after many views. The data at the moment has changed for a little bit. The studies now concluded that ATRA+ATO as front-line th in high risk patients are excellent choice for management of the disease

    posted by: Ivan Petkovic on 2014-10-01 02:03 PM (Europe/Berlin)