Akute Promyelozyten-Leukämie: Neue Behandlungsstrategien mit ATRA und ATO – AML-BFM-Empfehlungen

Zusammenfassung

Die Behandlung der Akuten Promyelozyten-Leukämie (APL) hat sich in den letzten Jahren deutlich geändert. Heute können APL Patienten mit Standardrisiko – (auch als Niedrigrisiko bezeichnet) ohne Chemotherapie nur mit all-trans-Retinsäure (ATRA) und Arsentrioxid (ATO) behandelt werden. Bei Hochrisikopatienten sollte eine Induktions-Chemotherapie hinzugefügt werden. Die kurativen Ergebnisse sind gut und vergleichbar mit jenen, die in der Vergangenheit mit Chemotherapie plus ATRA erzielt wurden. Toxizitäten, insbesondere infektiöse Komplikationen sind jedoch deutlich seltener. Das Hauptrisiko bleiben frühe letale Blutungen. Durch rechtzeitige Diagnose und frühe ATRA-Behandlung kann dieses Risiko reduziert werden. In der vorliegenden Übersicht werden die aktuellen Behandlungsstrategien und Empfehlungen für APL bei Kindern dargestellt und diskutiert.

Abstract

The treatment of acute promyelocytic leukemia (APL) has changed significantly in recent years. Today, APL patients with standard risk (also known as low risk) can be treated chemotherapy-free only with all-trans-retinoic acid (ATRA) and arsenic trioxide (ATO). For high-risk patients, induction chemotherapy should be added. The curative results are good and comparable to those achieved in the past with chemotherapy plus ATRA. However, toxicities, especially infectious complications, are reduced. The main risk remains early lethal bleeding. Timely diagnosis and early ATRA treatment can reduce this risk. This review presents and discusses current treatment strategies and recommendations for APL in children.

Schlüsselwörter

Akute Promyelozytenleukämie - Kinder - ATRA - Arsentrioxid

Key words

acute promyelocytic leukemia - children - ATRA - Arsenic

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