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Description

It is a substitution of Arginine for glutamic acid at position 3 and the addition of 13 amino acids results in a longer half-life

133 An epidemiological investigation revealed a correlation between exposure to mercury with cancer causes

OAG-0w, OAG-2w, OAG-16w

Although anthracyclines may also increase the risk of miscarriage, fetal malformations, and low birth weight, chemotherapy is needed with the recommended anthracycline being daunorubicin, due to its well-known efficacy in APL, and the limited evidence against the use of idarubicin that has a greater ability to cross the placental barrier.6,100 Considering the benefits of the ATRA association with chemotherapy, the appropriate timing for introducing ATRA should be discussed individually.6 In the second and third trimesters, ATRA should be initiated immediately, as has been recommended by the European LeukemiaNet since 2009.6 It can be used with relative safety in the second and third trimesters of pregnancy with no cases of fetal malformations, although delayed fetal growth and fetal arrhythmia have been reported.101 ATO is genotoxic, teratogenic, and carcinogenic, as demonstrated by studies in animal models and environmental risk studies.99,102,103 Since it crosses the placental barrier, it is recommended to avoid its use throughout pregnancy.6 However, a report has described the use of ATRA and ATO during pregnancy with a favorable outcome for both mother and fetus, suggesting that this is a question of debate considering that this combination is currently the best therapeutic approach for APL.104 Another challenge is the choice of delivery type, which must be based on each patient's conditions