Resistance to Arsenic Therapy in Acute Promyelocytic Leukemia

Although resistance to arsenic trioxide in patients with acute promyelocytic leukemia is very rare, mutations in PML at the site of arsenic binding appears to be the main mechanism of resistance. To the Editor: Acute promyelocytic leukemia (APL) is a highly curable disease. Recently, two randomized...

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Veröffentlicht in:The New England journal of medicine 2014-05, Vol.370 (19), p.1864-1866
Hauptverfasser: Zhu, Hong-Hu, Qin, Ya-Zhen, Huang, Xiao-Jun
Format: Artikel
Sprache:eng
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Zusammenfassung:Although resistance to arsenic trioxide in patients with acute promyelocytic leukemia is very rare, mutations in PML at the site of arsenic binding appears to be the main mechanism of resistance. To the Editor: Acute promyelocytic leukemia (APL) is a highly curable disease. Recently, two randomized trials conducted by Lo-Coco et al. 1 and our group 2 provided strong evidence supporting front-line treatment with arsenic trioxide and all- trans retinoic acid (ATRA) for APL. This treatment has been adopted by the most recent National Comprehensive Cancer Network guidelines. 1 The direct-binding targets of arsenic trioxide in the promyelocytic leukemia protein (PML) B2 domain are required to induce a molecular response in APL. 3 , 4 Mutant PML-C212/213 has been shown to lead to resistance to arsenic trioxide in an ex vivo model, but this association has . . .
ISSN:0028-4793
1533-4406
DOI:10.1056/NEJMc1316382