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Reinduction of relapsed acute promyelocytic leukemia with ATRA and low dose antimetabolite‐based chemotherapy
Author(s) -
Dvorak Christopher C.,
Sanders Robert P.,
Dahl Gary V.H.,
Donaldson Sarah S.,
Razzouk Bassem I.
Publication year - 2007
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20592
Subject(s) - medicine , acute promyelocytic leukemia , arsenic trioxide , antimetabolite , chemotherapy , methotrexate , cytarabine , hematopoietic stem cell transplantation , blood cancer , regimen , oncology , leukemia , surgery , retinoic acid , transplantation , cancer , apoptosis , biochemistry , chemistry , gene
While the disease‐free survival of acute promyelocytic leukemia (APML) now approaches 75%, some children continue to experience relapses, and questions remain as to the optimal management of these patients. We describe two young children who experienced combined relapses in the bone marrow and extramedullary locations following hematopoietic stem cell transplantation (HSCT). An induction regimen, consisting of all‐trans retinoic acid (ATRA), methotrexate, and 6‐mercaptopurine (6MP), successfully and safely achieved hematologic remission in one patient and molecular remission in the other. These cases demonstrate that there is a role for ATRA plus differentiating chemotherapy other than arsenic trioxide in the treatment of relapsed APML. Pediatr Blood Cancer 2007;48:582–585. © 2005 Wiley‐Liss, Inc.