- How is childhood leukemia treated?
- Immediate treatment of childhood leukemia
- Surgery for childhood leukemia
- Radiation treatment for childhood leukemia
- Chemotherapy for childhood leukemia
- Targeted therapy for childhood leukemia
- High-dose chemotherapy and stem cell transplant for childhood leukemia
- Treatment of children with acute lymphocytic leukemia
- Treatment of children with acute myeloid leukemia
- Treatment of children with acute promyelocytic leukemia
- Treatment of children with juvenile myelomonocytic leukemia
- Treatment of children with chronic myelogenous leukemia
- More information on treating childhood leukemia
- Status of acute leukemia after treatment
- Clinical trials for childhood leukemia
- Complementary and alternative therapies for childhood leukemia
Treatment of children with acute promyelocytic leukemia
Treatment of acute promyelocytic leukemia (APL) differs from usual AML treatment. Most children respond well to this treatment.
Many children with APL may have blood-clotting problems, which can be serious. They may be given a "blood thinner" to help prevent or treat this.
Along with chemotherapy (chemo), children with APL get a drug something like vitamin A called ATRA (all-trans retinoic acid). Although ATRA alone often brings about a remission, combining it with chemo gives better long-term results.
Spread to the brain or spinal cord is very rare with APL, so these areas most often do not need to be treated with chemo.
The side effects of ATRA treatment differ from those of standard AML chemo because of a possible problem called retinoic acid syndrome. It can include breathing problems due to fluid build-up in the lungs, low blood pressure, kidney damage, and severe fluid build-up elsewhere in the body. It can often be treated by stopping the ATRA for a while and giving a steroid.
This is usually much like induction, involving both ATRA and chemo. Because of the success of this treatment, stem cell transplant is not usually advised as long as the child stays in remission.
Children with APL may get maintenance therapy with ATRA, often with chemo, for about a year.
If the leukemia comes back after treatment, most children can be put into a second remission. Arsenic trioxide is a drug that works very well in this setting, but it can sometimes cause problems with heart rhythms. Children getting this drug need to have their blood mineral levels watched closely. ATRA plus chemotherapy may be another option. A stem cell transplant may be considered once a second remission is brought about.
Last Medical Review: 06/29/2012
Last Revised: 01/21/2013