Treatments for acute promyelocytic leukaemia (APL)

ATRA (All Trans-Retinoic Acid)

ATRA is given for up to three months alongside chemotherapy to people with acute promyelocytic leukaemia (APL). It makes the leukaemia cells mature, which can reduce leukaemia symptoms very quickly. ATRA is also known as tretinoin (Vesanoid®). It’s available as a capsule that is taken by mouth, with food. It’s based on the natural substance vitamin A and is not a chemotherapy drug. However, it does have some side effects, which can include:

  • headaches
  • dry skin and mouth
  • feeling sick (nausea)
  • bone pain
  • dry eyes.

ATRA in pregnancy

It’s important not to become pregnant or father a child while taking ATRA, as it may harm the developing baby. It’s important to use effective contraception while taking this drug, and for at least a few months afterwards. Your doctor or nurse will discuss this with you.

If you’re already pregnant, ATRA shouldn’t be given if you’re less than 12 weeks pregnant. After 12 weeks, it can be given safely. It’s usually given without chemotherapy, as this is safer for the baby and still effective.

Arsenic trioxide (ATO, Trisenox®)

Arsenic trioxide is licensed to treat people with APL that has come back after treatment, or has not gone into remission with treatment. It’s given at a low dose through a drip.

Side effects can include:

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Making treatment decisions

Your doctors may tell you there are different options for your treatment. Having the right information will help you make the right decision for you.


Chemotherapy uses drugs to treat leukaemia. It is most commonly given as an injection into a vein or as tablets or capsules.

Life after treatment

You might be thinking about how to get back to normal following treatment. Find advice, information and support about coping with and after treatment for leukaemia.