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Treatment of Recurrent APL
Source: Childhood Acute Promyelocytic Leukemia Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: June 14, 2024 · Captured 2026-09-09.
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Historically, 10% to 20% of patients with acute promyelocytic leukemia (APL) relapsed. However, current studies that incorporated arsenic trioxide therapy showed a cumulative incidence of relapse of less than 5%.[1-3]
In patients with APL who initially received chemotherapy-based treatments, the duration of first remission was prognostic. Patients who relapsed within 12 to 18 months of initial diagnosis had a worse outcome.[4-6]
An important issue in children who relapsed is the exposure to anthracyclines received in previous trials, which ranged from 400 mg/m2 to 750 mg/m2.[7] Thus, regimens containing anthracyclines were often not optimal for children with APL who relapsed.
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Treatment options for children with recurrent APL may include the following:
Arsenic trioxide with or without tretinoin.
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Gemtuzumab ozogamicin.
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Hematopoietic stem cell transplant (HSCT).
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Preserved source evidence · Not medical advice