Acute Promyelocytic Leukemia

P2/3, N=20, Not yet recruiting, The Affiliated People's Hospital of Ningbo University | N=60 --> 20

Both patients showed substantial improvement in regard to their complete blood count parameters after switching to sublingual ATRA, suggesting that this route of administration may be needed for individuals with APL who have altered gastrointestinal anatomy that may lead to suboptimal bioavailability. Overall, the pharmacodynamics of ATRA in patients with conditions affecting systemic drug absorption require further investigation.

Clinically available SFK inhibitors, particularly dasatinib, synergistically enhance ATRA-induced myeloid differentiation of NB4 APL cells and are more effective than the conventional ATRA plus ATO combination in this in vitro model. These findings support further preclinical and clinical evaluation of SFK inhibitor plus ATRA combinations as differentiation-oriented strategies and potential alternatives or complements to ATO-containing regimens in APL.

We report an octogenarian man with chronic-phase CML who was intolerant to multiple tyrosine kinase inhibitors and underwent temporary discontinuation of asciminib. All-trans retinoic acid plus arsenic trioxide achieved molecular remission of PML::RARA and was followed by an initial marked reduction in BCR::ABL1 transcript levels, which subsequently remained detectable at low levels during continued follow-up. This case highlights the importance of integrated cytogenetic and molecular evaluation to distinguish blast phase from independent leukemogenesis in patients with CML who develop cytopenias.

Analysis of public APL datasets revealed that high TCEA1 expression is associated with a favorable prognosis (HR = 0.43, 95% CI: 0.2-0.93, logrank p = 0.028). Collectively, our findings demonstrate that TCEA1 suppresses proliferation, promotes apoptosis and differentiation, and attenuates disease progression by upregulating C/EBPε and IRF8, positioning this regulatory mechanism as a potential therapeutic target and prognostic biomarker for this disease.

Synergism with doxorubicin (DOX) and other chemotherapeutic agents was quantified by combination index (CI) analysis using the Chou-Talalay method and spheroid culture assays...AAP similarly synergized with daunorubicin but not with etoposide or cytarabine, suggesting selectivity for ROS-inducing anthracyclines. These findings establish AMF-derived peptides as promising human-origin chemosensitizers capable of overcoming multidrug resistance in HMs through multi-targeted mechanisms. The ability to reduce anthracycline dosing while maintaining efficacy offers potential for minimizing cardiotoxicity and other dose-limiting adverse effects, warranting further preclinical development toward clinical translation.

Targeted therapies have yielded breakthroughs in treatment response and overall survival, such as all-trans retinoic acid/arsenic trioxide (ATRA/ATO) for acute promyelocytic leukemia (APL), or FLT3 inhibitors, IDH inhibitors, and menin inhibitors for AML harboring actionable genetic lesions...The documented effects of GHRH-R antagonism raise the possibility that it could influence signaling networks relevant to therapeutic resistance in AML. This hypothesis remains speculative; to date no studies have stratified AML by FLT3 status in the context of GHRH-R expression or GHRH antagonism, and there is currently no evidence that MIA-602 directly alters FLT3 receptor signaling or inhibitor sensitivity.

Faggot-like Auer bodies, once considered a hallmark of APL, are not pathognomonic for APL, and diagnosis based solely on morphology is susceptible to misdiagnosis. This report aims to accumulate clinical experience, provide a reference for the diagnosis and management of similar cases, and reduce the incidence of misdiagnosis and missed diagnosis.

Upadacitinib is an oral selective Janus kinase 1 (JAK1) inhibitor that targets specific pathways in immune-inflammatory responses. The patient achieved complete remission following standard induction therapy with all-trans retinoic acid and arsenic trioxide, with an uneventful treatment course. Notably, this clinical presentation markedly differs from typical APL cases, demonstrating unique biological characteristics.

APLL is characterized by significant endothelial damage, which is quantifiable by EASIX to independently contribute to the elevated MBE risk. The EASIX-based stratification can be utilized to rapidly identify high-risk APLL, who may benefit from an optimized VEN-HMA induction strategy to reduce ED risk.

Due to resource constraints, all-trans retinoic acid-based therapy was unavailable, and induction chemotherapy was administered, with a fatal outcome after one week. This case highlights gingival hypertrophy as an atypical early presentation and the impact of delayed diagnosis and limited access to essential therapy.