Can we say farewell to monitoring minimal residual disease in acute promyelocytic leukaemia?
| Autor: | David Grimwade, Robert Kerrin Hills, Jelena V. Jovanovic |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Neoplasm Residual Oncogene Proteins Fusion Leukocytosis Clinical Biochemistry Salvage therapy Tretinoin Kaplan-Meier Estimate Disease Real-Time Polymerase Chain Reaction Arsenicals Arsenic Trioxide Leukemia Promyelocytic Acute Inherent risk Antineoplastic Combined Chemotherapy Protocols Biomarkers Tumor Humans Medicine Anthracyclines Disease management (health) Intensive care medicine Salvage Therapy Clinical Trials as Topic business.industry Remission Induction Disease Management Historically Controlled Study Cell Differentiation Oxides Minimal residual disease Clinical trial Oncology Drug Resistance Neoplasm Immunology Personalized medicine Drug Monitoring medicine.symptom business |
| Zdroj: | Best Practice & Research Clinical Haematology. 27:53-61 |
| ISSN: | 1521-6926 |
| Popis: | Molecularly targeted therapies have transformed the management of PML-RARA+ acute promyelocytic leukaemia (APL), with survival rates now exceeding 80% in clinical trials. This raises questions about the relevance of post-remission monitoring for PML-RARA transcripts, which has been widely used to predict relapse, guiding early intervention to prevent disease progression and the inherent risk of fatal bleeding. Given the treatability of haematological relapse, survival benefits would only be seen if monitoring could identify patients who could be salvaged if treated early but not later on, although it could be argued that early deployment of arsenic trioxide (ATO) can avoid inducing hyperleucocytosis and the associated differentiation syndrome, which frequently complicate treatment of frank relapse. However, given the low rates of relapse now observed in patients presenting with standard risk disease (i.e. presenting WBC |
| Databáze: | OpenAIRE |
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