Discoveries in cancer research are rarely so exceptional thatthey both cause immediate changes in the treatment of patientsand dramatically advance our understanding of the mechanismsunderlying the disease. However, observations of the strikingefficacy of all-trans-retinoic acid (tretinoin) in the treatmentof patients with acute promyelocytic leukemia, followed closelyby the discovery of a specific molecular genetic abnormalityin a retinoid receptor, have greatly expanded scientific insightabout leukemogenesis and have radically altered treatment strategiesin this illness. The observation of tumor cells undergoing maturationas a patient enters remission has also provided a remarkabledemonstration of drug-induced . . . [Full Text of this Article]
Background
Molecular Genetics of Acute Promyelocytic Leukemia
Retinoids, Retinoid Receptors, and the PML Gene
PML/RAR-alpha and Leukemogenesis
Clinical Activity of Retinoic Acid in Acute Promyelocytic Leukemia
Induction of Remission
Predictiveness of Clinical Response
Duration of Remission
Acquired Resistance
Mechanism of Action
Adverse Effects
Leukocytosis and the "Retinoic Acid Syndrome"
Treatment Recommendations in Acute Promyelocytic Leukemia
Assessment of Minimal Residual Disease
Summary
Source Information
From the Developmental Chemotherapy and Leukemia Services, Department of Medicine, Memorial Sloan-Kettering Cancer Center, Cornell University Medical College, New York (R.P.W.); the Shanghai Institute of Hematology, Shanghai Second Medical University, People's Republic of China (Z.-Y.W.); and the Institut Universitaire d'Hematologie, Hopital St. Louis, University of Paris, Paris (H.T., L.D.).
Address reprint requests to Dr. Warrell at the Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021.
References
Appendix
Related Letters:
Acute Promyelocytic Leukemia
Stadler M., Ganser A., Hoelzer D., Izumi T., Hatake K., Miura Y., Warrell R. P., Degos L.
Extract |
Full Text
N Engl J Med 1994;
330:140-141, Jan 13, 1994.
Correspondence
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(1997). Leukemia-associated retinoic acid receptor alpha fusion partners, PML and PLZF, heterodimerize and colocalize to nuclear bodies. Proc. Natl. Acad. Sci. USA
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Tobita, T., Takeshita, A., Kitamura, K., Ohnishi, K., Yanagi, M., Hiraoka, A., Karasuno, T., Takeuchi, M., Miyawaki, S., Ueda, R., Naoe, T., Ohno, R.
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Mandelli, F., Diverio, D., Avvisati, G., Luciano, A., Barbui, T., Bernasconi, C., Broccia, G., Cerri, R., Falda, M., Fioritoni, G., Leoni, F., Liso, V., Petti, M. C., Rodeghiero, F., Saglio, G., Vegna, M. L., Visani, G., Jehn, U., Willemze, R., Muus, P., Pelicci, P. G., Biondi, A., Lo Coco, F.
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Benedetti, L., Levin, A. A., Scicchitano, B. M., Grignani, F., Allenby, G., Diverio, D., Lo Coco, F., Avvisati, G., Ruthardt, M., Adamo, S., Pelicci, P. G., Nervi, C.
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