Tretinoin and Arsenic Trioxide in Treating Patients With Untreated Acute Promyelocytic Leukemia

This study is for children and young adults, aged between 12 months and 21 years old, who have a new diagnosis of Acute Promyelocytic Leukaemia (APL). Doctors will confirm your diagnosis using samples from your bone marrow or blood. It's important that your leukaemia hasn't come back after previous treatment, or developed because of earlier chemotherapy or radiation.

Before joining, doctors will need to check your medical history to make sure this study is the right fit for you. They will also need to confirm that certain genetic markers linked to APL are present in your cells. You might be able to start taking one of the study drugs, tretinoin, for a few days before officially starting the main treatment in the study.

If you have any symptoms that make doctors suspect the cancer has spread to your brain or spinal cord, they might do extra scans. However, they will make sure any bleeding risks are under control before performing certain procedures like a spinal tap. The most important thing is that both you (if you're old enough) and your parents or legal guardians understand and agree to take part by signing a consent form.

If you join this study, your treatment will involve two main medicines: tretinoin, which you'll take by mouth twice a day, and arsenic trioxide, which will be given directly into your vein over a few hours each day for about a month. Depending on your specific type of APL (whether it's considered 'standard risk' or 'high risk'), you might also receive other medicines like dexamethasone (taken by mouth or given into a vein) and idarubicin (given into a vein).

Throughout the treatment, you will have regular visits to the hospital for checks, blood tests, and to receive your medication. Doctors will closely monitor how you're responding to the treatment. You'll also be asked to fill out questionnaires to assess your quality of life and how you're feeling. The study involves different phases of treatment, starting with an 'induction therapy' phase to get the cancer under control. If this is successful, you'll likely move on to a 'consolidation therapy' phase. The total duration of the study treatment and follow-up will be explained by your medical team.