All-trans-retinoic acid (ATRA) has been proven to lead to complete remission of acute promyelocytic leukemia by inducing differentiation into granulocytes except when an acquired resistance occurred. High levels of low density lipoprotein (LDL) receptor in cancer cells suggested the use of ATRA incorporated into LDL. 50% of HL-60 cell differentiation were obtained with 5 nmoles/l of ATRA-LDL compared to 150 moles/l of ATRA. Maximal differentiation (80%) was reached at 25 nmoles/l and 1,000 nmoles/l respectively. This higher efficiency suggests the involvement of LDL receptor in ATRA-LDL internalization and/or the protection of the drug, from eventual catabolism, by LDL particles.

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