Treatment & Prognosis of Promyelocytic Leukemia
Promyelocytic leukemia--also known as APL, or acute progranulocytic leukemia--is a specific form of leukemia, or cancer of the blood. While many types of leukemia are difficult to treat and control, there are a number of highly successful promyelocytic leukemia treatments that can greatly increase the chance of recovery from the disease.
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Definition
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In individuals suffering from promyelocytic leukemia, the bone marrow produces such an excess of abnormal white blood cells that the regular production of red blood cells is disrupted. As the disease progresses, symptoms include unexplained weight loss, anemia, a tendency to bruise and/or bleed easily, shortness of breath, weakness and an abnormal susceptibility to infections.
Treatments
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There are three main types of treatments used for patients with promyelocytic leukemia: treatment with ATRA (all-trans retinoic acid), stem cell transplantation, and treatment with an oxide of arsenic, known as arsenic trioxide. However, the most successful treatment option of all three is the use of ATRA.
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ATRA Treatment
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ATRA treatment in promyelocytic leukemia patients induces the abnormal white blood cells in the bone marrow to develop into mature white blood cells; this differentiation causes them to stop proliferating and crowding out the production of red blood cells. ATRA treatment is commonly used in conjunction with chemotherapy, since the two together have proven to be more effective than ATRA treatment alone.
Side Effects of ATRA
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ATRA treatment has one major side effect: the development of retinoic acid syndrome, a serious condition that causes weight gain, severe shortness of breath, a sharp drop in blood pressure, and fever. If a promyelocytic leukemia patient develops retinoic acid sydrome, she must be treated with dexamethasone, a strong immunosuppressant.
Prognosis
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With the use of ATRA treatment, over 90 percent of promyelocytic leukemia patients end up going into remission. If the ATRA treatment is combined with chemotherapy, nearly 75 percent can be completely cured.
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References
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