Practice Points, Consensus, and Controversial Issues in the Management of Patients with Newly Diagnosed Acute Promyelocytic Leukemia

Abstract

Learning Objectives: After completing this course, the reader will be able to: Manage patients with a suspicion of APL.Select appropriate diagnostic tools and strategies for rapid genetic diagnosis and molecular monitoring of minimal residual disease in APL patients.Select appropriate frontline treatment and supportive care for patients with APL.Provide practice points for appropriate evaluation of response. Access and take the CME test online and receive 1 AMA PRA category 1 credit at CME.TheOncologist.com Recent reviews on acute promyelocytic leukemia (APL) treatment have focused on comparing therapeutic approaches, including all-trans retinoic acid (ATRA) and chemotherapy, and do not address several other aspects of APL management that are relevant to the outcome in individual patients. These aspects include appropriate diagnostic tools and strategies, supportive care, recognition and treatment of life-threatening complications, evaluation of response, and, finally, management of the disease in special conditions such as older patients and pregnant women. In addition to reviewing current consensus and controversies of ATRA and chemotherapy treatment, this article addresses the above issues of APL management with special emphasis on aspects that distinguish APL from other acute myelogenous leukemias.