What are the National Comprehensive Cancer Network (NCCN) guidelines for supportive care in the treatment of acute promyelocytic leukemia (APL)?

Updated: May 26, 2020
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

For individuals receiving treatment for APL, the supportive care recommendations also include the following:

  • Aggressive transfusion support with platelets, fresh frozen plasma (FFP), and cryoprecipitate to manage clinical coagulopathy and overt bleeding

  • Close monitoring for possible APL differentiation syndrome, with initiation of dexamethasone at the first sign of symptoms such as acute weight gain (monitor daily weights) and shortness of breath.

  • Prophylaxis with prednisone for individuals receiving ATRA plus arsenic trioxide

  • In patients receiving arsenic trioxide, monitoring with serial electrocardiograms (to evaluate the corrected QT interval) and meticulous replacement of potassium and magnesium, to maintain high-normal levels of these electrolytes


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