Differentiation therapy for acute promyelocytic leukemia with all-trans retinoic acid: 10-year experience of its clinical application

Purpose To summarize the experiences in using all-trans retinoic acid (ATRA ) for the differentiation therapy for acute promyelocytic leukemia (APL) si nce our introduction of its use in clinic in 1986. Data resources Data resources came from Chinese Journal of Hematology, English-language li terature using MEDLINE (1988 - 1998), book entitled "Treatment of Malignanc ies by Inducing Differentiation and Apoptosis" published by Shanghai Publis hing House on Sciences and Technology, and our recent data to be published. Study selection Thirty-five articles related to the purpose of this review were reviewed. Data extraction Data were checked for their quality, reliance and originali ty. Data were checked for their quality, Results ATRA combined with chemotherapy can decrease the incidence of retin oic acid syndrome and produce a very high remission rate (90% - 95%). Post- remission treatment should include chemotherapy and ATRA, the 5-year surviv al probability was able to attain 0.71 +/- 0.06. The main problem in the tr eatment is early tolerance to ATRA and relapse of the disease. The most eff ective treatments for relapsed APL is to use arsenic trioxide. Conclusion The combination of ATRA, chemotherapy and arsenic oxide in the t reatment of APL for elevating the remission rate and prolonging survival ti me deserves further study.