Hematopoietic cell transplantation in acute promyelocytic leukemia: a comprehensive review

Biol Blood Marrow Transplant. 2007 Sep;13(9):997-1004. doi: 10.1016/j.bbmt.2007.05.005. Epub 2007 Jun 28.

Abstract

The past three decades have brought major therapeutic advances in the management of acute promyelocytic leukemia. The current state-of-the-art induction treatment with all-trans retinoic acid in combination with anthracycline-based chemotherapy results in long-lasting remissions and cure in up to 70% of newly diagnosed patients. Unfortunately, treatment failure still occurs in one-third of patients. When disease relapses, patients can achieve subsequent remissions with arsenic trioxide, all-trans retinoic acid with or without chemotherapy, or other therapies. Patients achieving molecular remissions after salvage therapy are generally considered candidates for high-dose chemotherapy and autologous hematopoietic cell transplantation as a postconsolidation strategy. On the other hand, patients with evidence of persistent hematologic or molecular disease after salvage therapy could be offered allogeneic hematopoietic transplantation if a suitable HLA-donor is identified and the patient's overall performance and clinical condition are permissible. We hereby provide a comprehensive review and analysis of published clinical trials that evaluate the role of hematopoietic cell transplantation across different stages of acute promyelocytic leukemia.

Publication types

  • Review

MeSH terms

  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Leukemia, Promyelocytic, Acute / diagnosis
  • Leukemia, Promyelocytic, Acute / therapy*
  • Salvage Therapy / methods
  • Treatment Failure