All-trans-Retinoic Acid in Acute Promyelocytic Leukemia

Acute promyelocytic leukemia is a distinct subtype of acute myeloid leukemia 1 in which a balanced reciprocal translocation between chromosomes 15 and 17 results in the union of portions of the promyelocytic leukemia gene with the gene for retinoic acid receptor alpha. 2 This chimeric gene encodes the promyelocytic leukemia–retinoic acid receptor alpha fusion protein. 3 – 6 Although 65 to 80 percent of patients with acute promyelocytic leukemia have a complete remission with standard chemotherapy, 7 , 8 approximately 10 to 20 percent die either before or during chemotherapy of bleeding attributable to disseminated intravascular coagulation, fibrinolysis, and proteolysis. 9 All- trans -retinoic acid differentiates leukemic . . .