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KMID : 0391319930030020207
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Korean Journal of Biological Response Modifiers
1993 Volume.3 No. 2 p.207 ~ p.216
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Clinical Significance and Molecular Assessement on Trial of All-trans-Retionic Acid for Patients with APL
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진종률
김동욱/이종욱/문한림/한치화/민우성/박종원/김춘추/김원일
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Abstract
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Background:
@EN Chemotherapy with anthracyclines combined with Ara-C has been the mainstay treatment of acute promyelocytic leukemia (APL) and 50%~60% complete remission rates were reported until recent years. All-trans-retinoic acid(ATRA) has demonstrated
in
vivo
and vitro effects that could differentiate leukemic cells in APL. We treated 12 APL patients with ATRA and evaluated the effectiveness.
@ES Methods:
@EN All patients were treated with ATRA (45mg/㎡/daily, P.O.) until achieving complete hematologic remission. Reverse transcription coupled with the polymerase chain reaction (PT/PCR) has been used to develop a diagnostic test for APL based on
the
PML/RARa fusion meassage.
@ES Results:
@EN Complete remission rates is approximately 83% (10/12 patients) in newly diagnosed, first relapsing and resistant APL patients to on or two courses of chemotherapy. One patient got CR with ATRA alone relapsed retinoic acid syndrome, but
effectively
managed with dexamethasone. To evaluate the feasibility of monitoring the APL clone by RT/PCR analysis, in 2 APL patients who had allogeneic and autologous BMT and two patients who received ATRA were evaluated in complete remission, PML/RARa
positive
cells were not detected in patients who had BMT, but continuously detected in the patients who had ATRA treatment alone.
@ES Conclusion:
@EN This preliminary results suggest that ATRA is very effective remission induction regimen in APL patients. But it seems that ATRA can not eradicate minimal residual leukemic clones. Additional intensive treatment such as BMT should be followed
after
CR with ATRA to improve the outcome of APL.
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KEYWORD
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