ACUTE PROMYELOCYTIC LEUKEMIA (APL): DIAGNOSIS AND TREATMENT
Journal Title: International Journal of Medical Laboratory Research - Year 2017, Vol 2, Issue 1
Abstract
Background:Acute Promyelocytic Leukemia (APL) is a subgroup of Acute Myeloid Leukemia(AML) with a different certain clinical period, biology and treatment. APL was the deadly leukemia but today it is most curable leukemia so that it could be treated with low cytotoxicity drugs such as All -Trans- Retinoic Acid (ATRA, tretinoin), and the best consolidation treatment in recurrence cases is Arsenic Trioxide (ATO,Trisenox). The purpose of this article is to introduce the APL, features and provides a rationale for the plan of risk-adapted protocols for further improving treatment outcome for this type of leukemia and reduce cytotoxicity of treatment protocols. Method: Search was performed on PubMed, MEDLINE, Science direct and Google scholar by using of keywords such as APL, treatment, M3 variant, various translocations. Result: we found 200 articles which we selected58 articles which have most relation with our subject.11articles about introduction, 9 articles about epidemiology and 38 articles about treatment.Articles werestudied and finally extracted their information. Conclusion: There are a series of tests for the diagnosis of APL, including Immunophenotyping, Histochemical methods such as Myeloperoxidase)MPO(, Sudan black B is positive and periodic acid Schiff (PAS) is negative and Nonspecific esterase <5% is weak positive and another diagnostic method is SpSp expression in AMLM3, M4. APL treatment was done with target therapy that was a new vision for leukemia treatment in order to use of drugs that have less toxicity and have the best response to treatment. It is associated with different translocation that is always involving retinoic acid receptor-α (RAR-α) gene with a variable partner gene (X-RARα or RARAα-X) that PML gene is the most partner gene. The partner gene has an impact on the response to ATRA,So that, 95% of patients were responsive to treatment with ATRA. The initial WBC and platelet count make associated with relapse, and determined the protocol cure and use or non-use of chemotherapy.
Authors and Affiliations
Aqmasheh Sara, Tari Kaveh, Karim Shamsasenjan, Shirjang Solmaz
Keywords
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