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APL — SCE Medical Oncology MCQ

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HardOncological EmergenciesAPLSCE Medical Oncology

A newly diagnosed patient has PML::RARA-positive acute promyelocytic leukaemia, white-cell count 7.8 ×10³/microlitre and no major contraindication to either standard induction approach. Which chemotherapy-free regimen is NICE recommended for this risk group?

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Correct answer: B — Arsenic trioxide plus ATRA for induction and consolidation

The white-cell count is no more than 10 ×10³/microlitre, defining untreated low-to-intermediate-risk APL in TA526. NICE recommends arsenic trioxide with ATRA for induction and consolidation in this group. ATRA must not be omitted, and conventional 7+3 is not the disease-specific comparator. In real practice, ATRA is started immediately when APL is suspected while confirmation and haemorrhage support proceed.

Reference: NICE TA526 arsenic trioxide for acute promyelocytic leukaemia (Published June 2018): https://www.nice.org.uk/guidance/ta526/chapter/1-Recommendations