How it Works

Retinoids such as ATRA are important regulators of cell reproduction, proliferation, and differentiation. ATRA works by promoting the differentiation of promyelocytes into mature white blood cells. When taken as directed, ATRA helps to restore the normal balance of blood cells in the body and can improve the symptoms of APL, stopping the cancer cells and slowing their growth.

ATRA is a medication that is commonly used to treat acute promyelocytic leukemia (APL), a subtype of acute myeloid leukemia (AML). APL is caused by a chromosomal abnormality called the t(15;17) translocation, which leads to the accumulation of abnormal promyelocytes (a type of white blood cell) in the bone marrow. These abnormal cells do not mature and instead accumulate in the bone marrow, leading to a shortage of normal blood cells and causing the symptoms of APL.

How it’s Administered

• ATRA is usually taken as a pill of 10mg that is taken orally. l It should be taken with food. without crushing, chewing or dissolving the capsules.
• You need to protect yourself from sunlight when taking the medication. 
• Treatment duration varies from 30-120 days until the acute promyelocytic leukemia (APL) completely disappears

Who Should Take (ATRA) 

• It is specifically indicated for the treatment of acute promyelocytic leukemia (APL) and should not be used in patients with other subtypes of AML
• Patients with a recent diagnosis of acute promyelocytic leukemia (APL)
• Patients with APL that have not responded to other treatments or that have  relapsed 
• Children with acute promyelocytic leukemia can also take this medication

Who Shouldn’t Take (ATRA) 

• Patients who are allergic to ATRA or any of its ingredients. 
• Pregnant women. It is important to inform your healthcare provider if you are pregnant, or planning to become pregnant before starting treatment, as it may cause harm to the fetus.
• Breastfeeding women should suspend breastfeeding if they start taking this medication. 
• ATRA may interact with certain medications, so patients taking tetracycline antibiotics, vitamin A or preparations containing vitamin A, low-dose progestogen oral contraceptives should stop these treatments before taking ATRA.
• It is important to inform your doctor about all medications that are being taken before starting treatment with ATRA.

The Most Common Side Effects of Taking (ATRA) Include:

• Headache, fever, dry skin, dry mucous membranes (mouth and nose), bone pain, nausea and vomiting, rash, mouth sores, itching, sweating, and eyesight changes.
• Changes in liver function tests, and cholesterol levels
• Differentiation syndrome is a very serious side effect that is preventable with proper monitoring and immediate treatment. This syndrome is a reaction between the drug and leukemia, which produces fever, difficulty breathing, weight gain, lung and heart problems. It is generally treated with high-dose steroids. In most cases, treatment with Tretinoin will continue. The syndrome usually occurs during the first month of treatment, with some cases reported following the first dose.

Commonly Used in Acute Myeloid Leukemia With

• Arsenic trioxide, to treat APL
• Anthracyclines (such as daunorubicin or idarubicin) and/or cytarabine, to treat APL.
• As a single drug therapy.

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Date Last Updated: 12/22/22