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Acute Promyelocytic Leukemia

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My research topic is about Leukemia. My goal is to inform about what leukemia is, the causes, the risk factors, the history of the disease, how it is treated, and how it could be treated in the future to increase curability and reduce mortality. My focus is going to be on a specific form of leukemia, called Acute Promyelocytic Leukemia, or AML3. It is called AML3 because it is the M3 subtype of a form of leukemia called Acute Myelocytic Leukemia.
Leukemia is a cancer of the blood and bone marrow. It forms when there is a mutation in the stem cells that form into various blood cells. This mutation causes the cells to replicate uncontrollably, and are put into the bloodstream while still immature. Since the blood is full of these immature cells, …show more content…

“Intracerebral and pulmonary hemorrhages are relatively common life-threatening complications occurring while the characteristic coagulopathy of APL is active. These complications are not only the most frequent cause of death early during induction therapy but can also occur before the diagnosis of APL has been made and therapy started (Sanz et al.).” Treatment with drugs such as 6-mercatopurine [sic] alone or with steroids, methyl-glyoxal guanyl hydrazine and/or methotrexate led to poor results, with remission rates of 5-14% and survival rates between 3 to 16 weeks for all patients, and 4 months to 6 years for patients that respond to treatment. In 1973, a new drug called daunorubicin (DNR) improved remission rates from 13 to 58% (Coombs et al.). Also during this period in time, studies into stem cell transplantation were being conducted, with varying success. “Allogeneic hematopoietic stem cell transplantation (HSCT) yielded poor results during first complete remission (CR1); however, allogeneic and autologous HSCT resulted in the longest CR2 durations (29 to 48+ months). (Coombs et al.)”. In other words, blood marrow stem cells taken from a donor other than the patient gives poor results, whereas …show more content…

Although many of the drugs used now are the same when AML3 was first discovered, we have found better ways of implementing them, and newer drugs to use either to supplement or replace altogether. One such drug is all-trans retinoic acid. all-trans retinoic acid, or ATRA, is a drug that “induces differentiation of leukemic promyelocytes into mature granulocytes. . . (Coombs et al.)”. On its own, ATRA produced complete remission rates of up to 72%, but unfortunately the patients suffered from frequent relapses. Another newer drug implemented in clinical settings was Arsenic Trioxide, or ATO. “ATO was first utilised in APL patients in the early 1990s, and led to a high CR rate with relatively long-term remissions when used as a single agent. In preclinical models, the combination of ATRA and ATO demonstrated synergism in inducing differentiation and apoptosis, allowing for targeted therapy of APL without chemotherapy. (Coombs et al.).” Basically, on their own, both drugs work fairly well, but together they work with each other to kill the leukemic cells. However, this was only in models. They still needed to prove themselves in a clinical environment over a wide range of patients. A group of South Asian cancer centers took the

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