A 32-year-old woman presents with gum bleeding and ecchymoses. CBC shows pancytopenia. Peripheral smear shows abnormal promyelocytes with abundant Auer rods (faggot cells). Bone marrow confirms acute promyelocytic leukemia (APL). Which targeted therapy is the cornerstone of initial treatment?
- A Imatinib
- B Rituximab
- C All-trans retinoic acid (ATRA) ✓
- D Venetoclax
Correct answer: C. All-trans retinoic acid (ATRA)
Explanation
APL is characterized by t(15;17) and a high risk of disseminated intravascular coagulation. All-trans retinoic acid induces differentiation of the leukemic promyelocytes and is the cornerstone of initial therapy, drastically reducing early mortality from DIC. Imatinib targets BCR-ABL in CML. Rituximab is anti-CD20 used in lymphomas. Venetoclax is used in AML or CLL.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.