Drug resistance mechanisms of acute promyelocytic leukemia to arsenic trioxide and its treatment progress

VernacularTitle:急性早幼粒细胞白血病亚砷酸耐药机制及治疗研究进展
Author: Qingtao MENG ¹ ; Zhengjun WU ; Xin LI ; Xianglei CHEN
Author Information

1. 潍坊市益都中心医院检验科，潍坊　262500
Keywords: Leukemia, promyelocytic, acute; Retinoic acid; Arsenites; Drug resistance mechanism; Treatment
From: Journal of Leukemia & Lymphoma 2025;34(6):381-384
CountryChina
Language:Chinese
Abstract: The dual induction therapy with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) has resulted in a cure rate exceeding 90% for patients with acute promyelocytic leukemia (APL). However, relapse due to ATO resistance remains a pressing clinical challenge. This article reviews recent research progress of PML mutations, metabolic adaptation, ATO metabolism, miRNA, snoRNA, the pathogenic mechanisms of the PML::RARA fusion protein and resistance mechanisms of autophagy. Additionally, the paper also discusses the clinical application of new treatment strategies such as venetoclax and gemtuzumab ozogamicin based on the drug-resistance mechanisms.