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Successful Treatment of Relapse of Acute Promyelocytic Leukemia with a New Synthetic Retinoid, Am80

Akihiro Takeshita, MD; Yukiko Shibata, MD; Kaori Shinjo, MD; Mitsuaki Yanagi, MD; Tadasu Tobita, MD; Kazunori Ohnishi, MD; Shuichi Miyawaki, MD; Koichi Shudo, PhD; and Ryuzo Ohno, MD
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Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1996;124(10):893-896. doi:10.7326/0003-4819-124-10-199605150-00006
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All-trans retinoic acid (ATRA) has proven to be a major advance in the management of patients with acute promyelocytic leukemia. Several studies [15] have shown that a treatment program using ATRA for induction followed by several cycles of cytotoxic chemotherapy for consolidation yields overall survival rates superior to those produced by chemotherapy alone. Nonetheless, ATRA has several important limitations, one of which is the rapid development of resistance to it by patients [6]. We report here, for the first time, that the new synthetic retinoid Am80 (4-[(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-naphthalenyl) carbamoyl] benzoic acid) (Figure 1) [78] induced complete remission without serious adverse effects in the only two patients whom we have treated with this drug for relapse from ATRA-induced complete remission of acute promyelocytic leukemia.

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Figure 1.
Molecular structures of Am80 and all-trans retinoic acid.
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Figure 2.
Clinical course of patient 1 after initiation of treatment with Am80.

Vertical bars indicate the differential count of bone marrow cells. Black represents blasts and promyelocytes, stripes represent normal myeloid cells, dots represent normal nucleated erythroid cells, and white represents the other cells. aPT = activated partial thromboplastin time; FBG = fibrinogen; FDP-DD = fibrin degradation products-D dimer; FFP(5) = fresh frozen plasma transfusion (5 units); Plt = platelet count; Plt.(10) = platelet transfusion (10 units); PT = prothrombin time; RBC = erythrocyte count; Ret = reticulocyte count; T-cho = total cholesterol level; TG = triglyceride level; WBC = leukocyte count.

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