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Genetic and Rare Diseases Information Center (GARD)

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Acute promyelocytic leukemia

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Your Question

I was diagnosed with acute promyelocytic leukemia 5 years ago. I have relapsed two times and have been on arsenic treatment since September 2010. My doctors don't know how to continue with my treatment as arsenic is not a controlled drug in Ireland. Can you provide me with information about treatment for this condition?

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

How might acute promyelocytic leukemia be treated?

Most cases of acute promyelocytic leukemia (APL) are treated with an anthracycline chemotherapy drug (daunorubicin or idarubicin) plus the non-chemotherapy drug, all-trans-retinoic acid (ATRA), which is a relative of vitamin A. This treatment leads to remission in 80% to 90% of patients.[1]

Patients who cannot tolerate an anthracycline drug may get ATRA plus another drug called arsenic trioxide.[1] Arsenic trioxide has also proven to be an effective alternative for the 20% to 30% of patients with APL who don't respond to initial treatment or who relapse. If treatment with arsenic trioxide achieves a remission, further courses of this drug may be given. An autologous stem cell transplant may also be an option. If a second remission is not achieved, treatment options may include an allogeneic stem cell transplant or taking part in a clinical trial.[2]

Additional information related to treatment of acute promyelocytic leukemia can be accessed through eMedicine. This includes detailed information related to the use of arsenic trioxide.

Last updated: 2/3/2012