TREATMENT OF ACUTE PROMYELOCYTIC LEUKEMIA WITH ADJUVANT TRANS-RETINOIC ACID - BENEFITS AND RISKS

Efficacy of cytostatic therapy of tumors is restricted by the risk of severe complications which may be life threatening. Acute promyelocyti c leukemia (APL) was one of the most prognostically unfavorable among other variants of acute leukemia because of apparent hemorrhagic syndr ome aggravating over the course of polychemotherapy. Introduction of t rans-retinoic acid (ATRA) to APL treatment provided remission in 96-98 % of APL patients with long-term survival of 70% of patients. ATRA war rants rapid correction of hemorrhagic syndrome with control of side ef fects by adequate measures, 8 APL children were treated by the protoco l APL-93 with ATRA and cytosar+rubomycini Syndrome of retinoic acid ob served in 3 cases was eliminated by dexamethasone (20 mg/m(2)/day). Al l the children achieved remission. The treatment is found highly effec tive and well tolerated.