Research: LO-COCO and COLLEAGUES,

Listed in Issue 242

Abstract

LO-COCO and COLLEAGUES, (1)Department of Biomedicine and Prevention, University Tor Vergata Santa Lucia Foundation, Rome, Italy University Hospital La Fe, University of Valencia, Valencia, Spain reviewed  therapeutic results obtained in patients with therapy-related acute promyelocytic leukemia (t-APL)  receiving conventional retinoic acid and chemotherapy and discuss new treatment opportunities with minimal or no exposure to conventional cytotoxic agents.

Background

Therapy-related acute promyelocytic leukemia (t-APL) has been increasingly reported after exposure to cytotoxic and/or immunosuppressive agents given for prior malignancies or autoimmune diseases. t-APL represents both a model for better understanding human leukemogenesis and an interesting therapeutic subset which requires specific adaptations for optimal management.

Methodology

The authors discuss here potential risk factors for t-APL development and the main biologic and clinical characteristics of t-APL as compared to de-novo APL. In addition, they review therapeutic results obtained in patients with t-APL receiving conventional retinoic acid and chemotherapy and discuss new treatment opportunities with minimal or no exposure to conventional cytotoxic agents.

Results

Genomic studies in patients at risk of t-APL are relevant to better adapt treatment for the primary disease and to implement monitoring during follow-up and early diagnosis of t-APL. Improved molecular characterization of t-APL may include next generation sequencing approaches to better identify distinguishing features as compared to de-novo APL.

Conclusion

Early diagnosis of t-APL through careful monitoring of patients at higher risk, coupled to incorporation in the therapeutic armamentarium of novel effective agents such as arsenic trioxide could result in improved clinical outcome for these patients.

References

Lo-Coco F(1), Hasan SK, Montesinos P, Sanz MA. Biology and management of therapy-related acute promyelocytic leukemia.  Curr Opin Oncol. 25(6):695-700. doi: 10.1097/CCO.0000000000000013.  Nov 2013.

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