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19 However, tumor cells also utilize GST to form a GSHX complex between antitumor drugs and GSH, proceeding to excrete the complex out of the cell by Pgp and MRP

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Other therapies that have been utilized include corticosteroids, acetazolamide, mannitol, glycerin, topiramate, and therapeutic lumbar puncture.71,73,77 There is a report of the use of mannitol and acetazolamide together with the suspension of ATRA to decrease the CSF pressure thereby improving the headaches, diplopia, nausea and vomiting in two days and improvement of papilledema in seven days.78 Topiramate, an anticonvulsant and carbonic anhydrase inhibitor, may also be used in cases not responsive to acetazolamide to improve symptoms.74 The temporary suspension of ATRA/ATO is recommended when there is diagnostic suspicion of PTC in patients with APL