What is Ato ATRA?
ATRA and ATO therapy is a combination treatment of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) which is now recognised as the first-line treatment for acute promyelocytic leukaemia (APL). A first-line treatment is accepted as the best initial treatment for a given type and stage of a disease.
What is ATRA APL?
ATRA is a form of vitamin A that is typically part of the initial (induction) treatment of APL. It is given either along with chemo, or along with arsenic trioxide for the initial treatment of APL.
How long is treatment for APL?
A bone marrow biopsy is usually done about a month after starting treatment, to see if the leukemia is in remission. Induction is typically continued until the APL is in remission, which might take up to 2 months.
What is high risk APL?
Summary: High-risk APL, traditionally defined by an initial white cell count exceeding 10 × 10⁹/l, has proven to be almost as amenable to disease eradication as low-risk and intermediate-risk APL, provided treatment includes ATRA, ATO and some chemotherapy.
What causes APL?
APL is caused by the uncontrolled proliferation of promyelocytes, a type of immature cell from the myeloid lineage of blood cells. The hallmark of APL is genetic alterations involving the retinoic acid receptor alpha (RARA) gene.
How do you get APL leukemia?
Cause. APL is caused by a chromosomal translocation (rearrangement of material) that occurs in some of the body’s cells during a person’s lifetime (a somatic mutation ). The translocation involves the fusion of two genes : the PML gene on chromosome 15 and the RARA gene on chromosome 17.
Is Ato a chemotherapy?
Arsenic trioxide is a chemotherapy drug and is also called Trisenox or ATO. It is a treatment for a type of acute myeloid leukaemia called acute promyelocytic leukaemia (APL).
Does APL come back?
Acute promyelocytic leukaemia (APL) treatment If you do go into remission, but the cancer comes back, this is known as a relapse. This is especially rare if you were treated with ATRA and arsenic trioxide.
Is APL curable?
Because of advances in diagnostic techniques and modern treatments, APL is today considered to be the most curable subtype of acute myeloid leukemia in adults, with complete remission rates of 90 percent and cure rates of approximately 80 percent and even higher among low-risk patients.
Is ATRA a chemotherapy?
ATRA is an anti-cancer (“antineoplastic” or “cytotoxic”) chemotherapy drug.
Is the ATRA + ATO approach effective in non-high risk APL?
Especially in patients with non-high-risk APL, the ATRA + ATO approach allowed significant increase in event-free survival and overall survival rates compared to standard ATRA and chemotherapy. This has been demonstrated by pilot studies and, more recently, by a randomized comparative multi-centre study conducted in Italy and Germany.
What is the role of ATO in front-line therapy of acute promyelocytic leukemia (APL)?
The role of ATO in front-line therapy of APL is under investigation. Recent findings: Pilot studies using ATO with or without all-trans retinoic acid (ATRA) have been carried out in newly diagnosed APL patients with the aim to reduce the short and long-term toxic effects of chemotherapy and to improve clinical outcome.
Does ATO with or without all-trans retinoic acid (ATRA) reduce toxic effects of chemotherapy?
Recent findings: Pilot studies using ATO with or without all-trans retinoic acid (ATRA) have been carried out in newly diagnosed APL patients with the aim to reduce the short and long-term toxic effects of chemotherapy and to improve clinical outcome.
How effective are ATRA and As2O3 combinations in acute promyelocytic leukemia?
The combination of all-trans retinoic acid (ATRA) and arsenic trioxide (As2O3, ATO) has been effective in obtaining high clinical complete remission (CR) rates in acute promyelocytic leukemia (APL), but the long-term efficacy and safety among newly diagnosed APL patients are unclear.