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Management of Treatment-Related Complications in APL

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Acute Promyelocytic Leukemia

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Abstract

Since the introduction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) in the treatment of acute promyelocytic leukemia (APL), new toxicities have emerged which may complicate the course of this disease. In this chapter we describe common and rare complications, other than thrombohemorrhagic, observed in patients with APL treated with ATRA and/or ATO as well as their management. Some of these complications are common to both agents (differentiation syndrome, hyperleukocytosis); others are more specific for ATRA (pseudotumor cerebri, mucocutaneous complications, moderate increase in triglyceride levels) or ATO (prolongation of QTc interval, neurotoxicity, and viral reactivation). The early recognition of these complications may, in some patients, improve the cure rate of APL now approaching 85–90% when treated with both these agents.

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  1. UOC Hematology, Stem Cell Transplantation, University Hospital Campus Bio Medico, Via Alvaro del Portillo 21, Rome, 00128, Italy

    Ombretta Annibali M.D., Ph.D. & Giuseppe Avvisati M.D., Ph.D.

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  1. Ombretta Annibali M.D., Ph.D.
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  2. Giuseppe Avvisati M.D., Ph.D.
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Correspondence to Giuseppe Avvisati M.D., Ph.D. .

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  1. Division of Hematology/Oncology, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada

    Oussama Abla

  2. Department of Hematology, University of Tor Vergata, Rome, Italy

    Francesco Lo Coco

  3. Department of Medicine, Hospital Universitari i Politecnic La Fe, University of Valencia, Valencia, Spain

    Miguel A. Sanz

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Annibali, O., Avvisati, G. (2018). Management of Treatment-Related Complications in APL. In: Abla, O., Lo Coco, F., Sanz, M. (eds) Acute Promyelocytic Leukemia . Springer, Cham. https://doi.org/10.1007/978-3-319-64257-4_21

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