Use of all-trans retinoic acid to treat acute promyelocytic leukemia: A case with very severe features at the onset in Nicaragua

• Published in: Medical and pediatric oncology Vol. 26; no. 4; pp. 258 - 260
• Main Authors: Flores, A., Malta, A., Pacheco, C., Baez, F., Ocampo, E., Conter, V., Masera, G., Biondi, A., Rovelli, A.
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01-04-1996; Wiley-Liss
• Subjects: acute promyelocytic leukemia; all-trans-retinoic acid; Antineoplastic agents; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - economics; Antineoplastic Agents - therapeutic use; Bacteremia - microbiology; Biological and medical sciences; Chemotherapy; Child; childhood; Developing Countries; Drug Costs; Female; Hemorrhage - etiology; Humans; Leukemia, Promyelocytic, Acute - drug therapy; Medical sciences; Nicaragua; Pharmacology. Drug treatments; Pseudomonas aeruginosa; Pseudomonas Infections; Remission Induction; Skin Diseases, Bacterial - etiology; Staphylococcal Skin Infections; Tretinoin - administration & dosage; Tretinoin - economics; Tretinoin - therapeutic use; Nicaragua; Human; Antineoplastic agent; Case study; Promyelocytic leukemia; Drug combination; Treatment; Acute; Female; Malignant hemopathy; Child; Retinoic acid
• ISSN: 0098-1532; 1096-911X
• DOI: 10.1002/(SICI)1096-911X(199604)26:4<258::AID-MPO7>3.0.CO;2-I

We observed a child with acute promyelocytic leukemia (APL) who, at the onset, had extremely severe hemorrhagic and septic complications. According to our experience in Nicaragua, there was a very high risk of early death. The patient was successfully treated with a program that included all‐trans retinoic acid (ATRA) followed by cytotoxic chemotherapy. ATRA has two important features: it is effective in initial treatment of APL and it is inexpensive. Because of the high cost and the need for extensive supportive care, optimal myeloablative therapy used in patients with various types of acute myeloid leukemia generally cannot be given in developing countries. ATRA treatment for APL is affordable everywhere. © 1996 Wiley‐Liss, Inc.