Acute Promyelocytic Leukemia: Current COG treatment for a unique AML subtype (C211)

4:45 –5:45 pm Thursday, September 13


1CH  Acute promyelocytic leukemia (APL), a sub-classification of acute myeloid leukemia (AML), is characterized by the t(15,17) gene mutation. Though survival rates for pediatric patients with newly diagnosed AML generally remain suboptimal, changes in treatment for the APL subtype, including the addition of arsenic trioxide (ATO), have improved survival rates to more than 90%.

Although its mechanism of action is not fully understood, ATO has demonstrated improved efficacy when used in combination with all-trans retinoic acid (ATRA).Treatment regimens for APL have historically included ATRA and anthracyclines as the backbone for all risk groups. In the Children’s Oncology Group protocol AAML0631, the total anthracycline dose was significantly decreased with the addition of ATO with the aim of minimizing cardiac toxicity. The current COG AAML1331 study aims to determine if eliminating or reducing the amount of conventional chemotherapy (including anthracyclines) used in APL treatment, through the use of ATRA and ATO-based therapy, will reduce toxicity while maintaining excellent survival outcomes. This session will review the COG AAML1331 protocol, including discussion of ATRA and ATO administration, and will highlight nursing care of patients enrolled on this clinical trial. During this session, innovative approaches to care and future directions for the treatment of patients with APL will be discussed, providing learners with new knowledge that can be applied in daily practice.