(APL)

(APL)

12345MDSMPN()((CNSL)1

()t(15;17) PML-RAR(PLZF-RARNuMA-RARNPM-RARStat5bRAR)FLT3-ITD2

3.APLt(15;17)PML-RARAPL (APLPLZF-RARNuMA-RARNPM-RARStat5bRAR )APL

(APL) (APL)

APL*/(WBC10 109/L)(WBC10109/L)ATRAATO a* ATRA72ATRA

ATRAATO6 Allo-HSCTAPL-2APL-3APL-1(APL)APLt1517PML-RAR

a ATRA 20mg/m2/d po ATO 0.16mg/kg/d ivgtt

* 46

PCR

/(WBC10 109/L)ATRA+ IDA/DNR+ ATO aATRA + IDA/DNR a* APL-4 Allo-HSCT

*ATRAb + IDA 8-12mg/m2/dDNR 45-90mg/m2/d3d 2APL-4ATOAllo-HSCTAPL-2a ATRA 20mg/m2/d poATO 0.16mg/kg/d ivgtt IDA 8-12mg/ m2/d iv2, 4, 6, 8 DNR 45-90mg/ m2/d iv2, 4, 6 8

b ATRA 20mg/ m2/d 14 (APL)ATRAb + IDA 8-12mg/m2/dDNR 45-90mg/m2/d3d 2

10109/LFLT3-ITDATRA + ATO + IDADNR aATRA + IDA aATRA + DNR (Ara-C) a*ATRAb + IDA 8-12mg/ m2/d DNR 45-90mg/ m2/d 3d+ Ara-C 150mg/ m2/d 7d 2 ATRAb + HHT 4mg/ m2/d 3d + Ara-C 1g/ m2 q12h 3d 1

ATO Allo-HSCT Allo-HSCTAPL-4APL-3(APL)a ATRA 20mg/m2/d po ATO 0.16mg/kg/d ivgtt IDA 8-12mg/ m2/d iv 2, 4, 6, 8 DNR 45-90mg/ m2/d iv 2, 4, 6 8 Ara-c 150mg/ m2/d iv 1-7

b ATRA 20mg/ m2/d 14 * 46

PCR

LPA 96 PFSLPA 96 EFS according to presenting WBC countWBCLPA 96_Blood_1999

LPA 96LPA 99LPA96LPA99AIDAATRA+IDALPA96LPA99ATRA

MTZ 1LPA992IDAIDALPA 99_Blood_2008

LPA 96LPA 99DFSCIRLPA995CIRDFS11%84%LPA 96P 0 .017 0.03LPA 99_Blood_2008

LPA 995LPA 99_Blood_20085CIR3%8%26%P

--LPA 96LPA 99LPA2005LPA2005LPA991240%LPA 2005_Blood_2010

LPA 2005LPA2005CIRP=0.03

LPA99LPA2005OSDFSCIRP

LPA 2005_Blood_2010

LPA99LPA2005CIR4CIR LPA99 27% LPA2005 14% P=0.03LPA 2005_Blood_2010

LPA99LPA2005DFSOSLPA2005DFS (P=.04) P.001 P=.04 LPA 2005_Blood_2010

AIDA-2000 GIMEMA_Blood_2010

CIRAIDA-2000 GIMEMA_Blood_2010

80ATRAAPLAPLAPLAIDAATRA+IDAAPL ATRA

ARTA+ATO2004ATRAATOAPLCR90%,PML-RARATRA+ATOProc Natl Acad Sci USA 2004;101(15):5328-35.2011NCCN

APL-4(APL)/ATRA 20mg/m2/d14d14(1)ATO 0.16mg/kg/d14d14 14d(2-3) 5

ATRA 20mg/m2/d14d14(1)ATOb 0.16mg/kg/d14d1414d(2-3)MTX 15 mg/m2/w 4w6-MP c 50 mg/m2/d 2-4W(3) 5a PCR(PML-RAR)b ATOSFDAAPLc 6-MPd 23PCR a4

dCRAPLAPL-64APL-5

European APL 93 EuroAPL93 10ATRA+6mp+MTXBlood.2010;115:1690-1696)

a b4

APLAPL-6a 3-66-12b

APL-5

APL-6APLAPLAPL

APL-7 APL APL a b() (CNSL)30-50109/LPPSBFG>150mg/dLPTAPTTDIC ATRA(10mg bid 2)/

3 6 >10109/L QTcCa,K,MgK>4mEq/dLMg>1.8mg/dlQTc>500 msAPL

APL-8