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ATO with or without chemotherapy
Source: Acute Myeloid Leukemia Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: March 14, 2025 · Captured 2026-09-09.
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Context: Treatment of Acute Promyelocytic Leukemia (APL) / Treatment of Recurrent APL
ATO has high rates of second remission in patients with relapsed APL.[10] As a single agent, ATO can lead to complete response rates of 80% to 90% in patients with hematologic relapse, and 70% to 80% in patients with molecular remission.[11-14] The choice of salvage therapy is based on the previous therapy and interval of time between first remission and relapse.
In patients with early relapse less than 6 months after ATRA and ATO, anthracycline-based regimens and ATRA as given for initial remission induction for high-risk disease should be considered.
In patients who relapse less than 6 months after ATRA and anthracycline-based regimens (no previous ATO exposure), ATO-based regimens should be considered.
In all patients with late relapse (>6 months), ATO-based regimens with or without anthracycline or gemtuzumab ozogamicin should be considered.
For patients receiving ATO as salvage therapy, a small randomized trial suggested that the addition of ATRA does not confer any benefit over ATO alone in patients who previously received ATRA.[14] In this 20-patient study, the complete response rate after one cycle of ATO with or without ATRA was 80%.
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Preserved source evidence · Not medical advice