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Although the combination of atra with anthracyclines has remarkable activity against low-risk APL (WBC < 5,000 and platelets > 20,000) (OS of 80%-90%), it is less active in patients with high-risk disease. Furthermore, there are long-term toxicities associated with the use of anthracyclines, including second malignancies (e.g., MDS and acute leukemia) and dilated cardiomyopathy.

Treatment of Acute Promyelocytic Leukemia