Lo-Coco Francesco, Cicconi Laura
Department of Biomedicine and Prevention, University Tor Vergata, Via Montpellier 1, 00133, Rome, Italy,
Curr Hematol Malig Rep. 2014 Jun;9(2):138-43. doi: 10.1007/s11899-014-0206-5.
Modern guidelines based on a large international consensus indicate that treatment of newly diagnosed acute promyelocytic leukemia (APL) requires distinguishing at presentation low-intermediate (<10 × 10(9)/L WBC) from high-risk (>10 × 10(9)/L WBC) disease. The concomitant use of all-trans retinoic acid (ATRA) and anthracycline based chemotherapy, with inclusion of AraC in consolidation for hyperleucocytic patients, has remained the standard of care for the past two decades. The advent of arsenic trioxide (ATO) and results from a large randomized trial, have recently challenged the standard ATRA-chemotherapy approach suggesting that at least patients in the low-intermediate category may be cured without chemotherapy using the ATRA-ATO combination.
基于广泛国际共识的现代指南表明，新诊断的急性早幼粒细胞白血病（APL）的治疗需要在初诊时区分低中危（白细胞计数<10×10⁹/L）和高危（白细胞计数>10×10⁹/L）疾病。在过去二十年中，全反式维甲酸（ATRA）与蒽环类化疗药物联合使用，并在高白细胞血症患者的巩固治疗中加入阿糖胞苷（AraC），一直是标准治疗方案。三氧化二砷（ATO）的出现以及一项大型随机试验的结果，最近对标准的ATRA-化疗方法提出了挑战，表明至少低中危组患者使用ATRA-ATO联合方案无需化疗即可治愈。
