Cardarelli Hospital, Division of Hematology and Stem Cell Transplantation Unit, Via Nicolò Piccinni 6, 80128 - Napoli, Italy.
Expert Opin Pharmacother. 2010 Mar;11(4):587-96. doi: 10.1517/14656560903505115.
Acute promyelocytic leukemia (APL) represents a paradigm of therapeutic success in clinical hematology. Since the introduction of all-trans-retinoic-acid in the early 1980s, complete remission rates exceed 90% and the cure rate is > 70%. Notwithstanding, various questions concerning the management of APL remain unanswered.
The aim of this article is to focus on still controversial issues in the management of APL, such as the role of arsenic trioxide as front-line therapy, the management of older unfit patients, the potential utility of gemtuzumab-ozogamycin and the effectiveness (if any) of maintenance therapy for patients in molecular remission. In addition, the possibility of reducing the intensity of post-remission therapy, which is associated with substantial morbidity in potentially cured patients, is discussed.
Current and future therapeutic options for the treatment of newly diagnosed and relapsed APL.
To date, the therapy of APL is the most successful example of differentiation therapy and its scientific history can serve as a model for subsequent development of similar treatments in other leukemias and cancers. However, treatment strategies continue to evolve rapidly, with particular focus on minimizing the early and late effects of cytotoxic chemotherapy.
急性早幼粒细胞白血病（APL）代表了临床血液学治疗成功的范例。自 20 世纪 80 年代初全反式维甲酸问世以来，完全缓解率超过 90%，治愈率超过 70%。尽管如此，关于 APL 管理的各种问题仍未得到解答。
本文旨在关注 APL 管理中仍存在争议的问题，例如三氧化二砷作为一线治疗的作用、不适合老年患者的管理、吉妥珠单抗奥佐米星的潜在效用以及分子缓解患者维持治疗的效果（如果有的话）。此外，还讨论了降低缓解后治疗强度的可能性，因为这会给有治愈可能的患者带来严重的发病率。
新诊断和复发 APL 的治疗的当前和未来治疗选择。
迄今为止，APL 的治疗是分化治疗最成功的范例，其科学历史可以作为随后在其他白血病和癌症中开发类似治疗方法的模型。然而，治疗策略仍在迅速发展，特别关注最大限度地减少细胞毒性化疗的早期和晚期影响。
