All-trans retinoic acid (Tretinoin)
Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.
| ID | DRUG-ATRA |
|---|---|
| Tipo | Fármaco |
| Aliaces | ATRAÁcido retinoico transTretinoínaVesanoidesТретиноїн (ATRA) |
| Situación | reviewed 2026-04-25 | pending_clinical_signoff |
| Enfermedades | DIS-APL |
| Fuentes | SRC-APL0406-LOCOCO-2013 SRC-ELN-APL-2019 SRC-NCCN-AML-2025 |
Datos sobre drogas
| Clase | Retinoide (derivado de la vitamina A); agente de diferenciación |
|---|---|
| Mecanismo | Binds retinoic-acid receptor α (RARα) and degrades the PML-RARα fusion oncoprotein in APL → forces blast differentiation rather than killing. Cornerstone of every APL induction regimen. |
| Dosificación típica | APL: 45 mg/m²/day PO divided BID until complete remission (typically ~30-50 days). Continue per consolidation/maintenance protocol. Initiate IMMEDIATELY at clinical APL suspicion (don't wait for cytogenetic confirmation) — mortality from bleeding > from leukemia in first 7 days. |
| Ucrania registrada | Cierto |
| NSZU reembolsado | Cierto |
| Ucrania verificada por última vez | 2026-04-27 |
Advertencias
- Differentiation syndrome (formerly RA-syndrome) — fever, dyspnea, weight gain, pulmonary infiltrates, hypotension; potentially fatal; treat with dexamethasone 10 mg IV BID
- Leucocitosis: la CMA alta al diagnóstico predice mayor riesgo de SD; esteroides profilácticos si la CAM es >5K (riesgo bajo) o >10K (risco alto)
- Teratogenicidad: el embarazo debe excluirse
Notas
Initiate ATRA at clinical APL suspicion based on smear findings + DIC pattern, BEFORE PML-RARα confirmation — early death from bleeding is the dominant APL mortality. Differentiation-syndrome prophylaxis with dexamethasone 10 mg IV BID for high-risk (WBC >10K) or rising WBC. Pregnancy-test gating + 2 forms of contraception mandatory.
Utilizado por
Esquema terapéutico
REG-ATRA-ATO-APL- ATRA + Trióxido de arsénico (APL bajo/riesgo intermedio) - APL0406 / calendario LO-CoCoREG-ATRA-ATO-APL-SALVAGE- ATRA + ATO de recuperación para R/R APL post-front-lineREG-ATRA-ATO-IDA-APL- ATRA + ATO + Idarubicin (APL high-risk) — modified APL0406 / AIDA-styleREG-GEMTUZUMAB-APL- Gemtuzumab ozogamicin for relapsed APL with maintenance