Creutzig Ursula, Dworzak Michael, von Neuhoff Nils, Rasche Mareike, Reinhardt Dirk
Pediatric Hematology/Oncology, Hannover Medical School Hannover, Hannover.
St. Anna Children's Hospital and Children's Cancer Research Institute/Medical University of Vienna, Vienna, Austria.
Klin Padiatr. 2018 Oct;230(6):299-304. doi: 10.1055/a-0750-5963. Epub 2018 Nov 6.
The treatment of acute promyelocytic leukemia (APL) has changed significantly in recent years. Today, APL patients with standard risk (also known as low risk) can be treated chemotherapy-free only with all-trans-retinoic acid (ATRA) and arsenic trioxide (ATO). For high-risk patients, induction chemotherapy should be added. The curative results are good and comparable to those achieved in the past with chemotherapy plus ATRA. However, toxicities, especially infectious complications, are reduced. The main risk remains early lethal bleeding. Timely diagnosis and early ATRA treatment can reduce this risk. This review presents and discusses current treatment strategies and recommendations for APL in children.
近年来,急性早幼粒细胞白血病(APL)的治疗发生了显著变化。如今,标准风险(也称为低风险)的APL患者仅使用全反式维甲酸(ATRA)和三氧化二砷(ATO)即可无需化疗进行治疗。对于高风险患者,则应添加诱导化疗。治疗效果良好,与过去化疗加ATRA所取得的效果相当。然而,毒性,尤其是感染并发症有所减少。主要风险仍然是早期致死性出血。及时诊断和早期ATRA治疗可降低这种风险。本综述介绍并讨论了儿童APL的当前治疗策略和建议。