Acute promyelocytic leukemia: current strategies for the treatment of newly diagnosed disease.

Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia that comprises about 10% of cases. It is characterized by the accumulation of granulocytic cells blocked at the promyelocytic stage of differentiation in the bone marrow and the peripheral blood, life-threatening coagulopathy, and a remarkable response to treatment with all-trans-retinoic acid (ATRA), arsenic trioxide, and anthracyclines. Current treatment strategies with ATRA and anthracycline-based chemotherapy has dramatically transformed APL into the most curable of all acute leukemias. Advances in supportive care together with the early recognition of treatment-related complications have also contributed significantly to increased cure rates. In this review we explore current treatment strategies in the management of newly diagnosed APL. We also highlight practical points that may serve as a guideline for the treating physician and address current controversies in the choice of treatment.