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However, long-term safety data, especially regarding cardiovascular safety, still need further accumulation
Combination therapy with arsenic trioxide, all-trans retinoic acid, and chemotherapy in acute promyelocytic leukemia patients with various relapse risks
1 Introduction Acute leukemias (ALs) are a group of malignant diseases of the hematopoietic system characterized by disordered proliferation and clonal expansion of immature precursors, resulting in bone marrow failure with blockage in cell differentiation processes ( Although the use of various chemotherapy schemes for the treatment of ALs has achieved a high percentage of survival in developed countries, in Colombia its implementation has shown discouraging results, with complete remission rates of 45% in AML and 61% in ALL in the adult population ( The lack of response to current chemotherapeutics has been attributed to different resistance mechanisms, among them: 1) the acquisition of new mutations or genetic alterations (clonal evolution) ( Reprogrammed metabolic activities of tumor cells that support survival, maintenance, and drug response are related to altered bioenergetic pathways, enhanced macromolecule biosynthesis, and maintenance of the redox balance ( In this review, we describe the intrinsic and extrinsic mechanisms that have been associated with alterations in glycolytic metabolism and mitochondrial function in chemoresistant leukemic cells and how natural products could reverse resistance with a metabolic and immunomodulatory approach
Corbo et al
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