Induction, consolidation, and maintenance therapies with arsenic as a single agent for acute promyelocytic leukaemia in a 11‐year follow‐up

Abstract

The aim of this study was to evaluate the effect of arsenic trioxide as a single agent in acute promyelocytic leukaemia cases for induction, consolidation, and maintenance therapy in a long-term, 11-year follow-up. We studied 60 patients with acute promyelocytic leukaemia. Sixty percent of the patients were aged between 12 and 24 years. Arsenic trioxide was infused at a 0.15 mg/kg daily dose until complete remission was achieved. After 2 weeks of rest, arsenic trioxide was infused daily for 28 days as a consolidation therapy. Then, arsenic infusions were given every 3-4 months for 14 days for 2 years, and the patients were followed until relapse or death. The rates of complete remission, disease-free survival, overall survival, and drug toxicity were evaluated. The morphologic complete remission was observed in 55 out of the 60 patients. The most common causes of a remission failure were early mortality because of the APL differentiation syndrome and the lack of response to arsenic treatment. The mean follow-up was 90 months. The primary outcomes for males and females were a mean disease-free survival of 101 and 97 months, respectively, and a mean overall survival of 103 and 101 months, respectively. From the 55 cases with remission, three patients died (late mortality). Of the 60 patients, 85% are still alive. Arsenic trioxide was generally well tolerated. The long-term follow-up of patients with APL, treated with arsenic alone as induction, consolidation, and maintenance therapy, shows high cure rates and excellent outcomes.

Improved long‐term survival in all Sanz risk patients of newly diagnosed acute promyelocytic leukemia treated with a combination of retinoic acid and arsenic trioxide‐based front‐line therapy

“…This finding was in line with recent reported data from current ATO‐based regimens have a t‐MN incidence of only 0% to 0.3% . Interestingly, Aznab M et al reported that there were no second malignancies including t‐MN during an 11‐year follow‐up for APL patients treated by ATO monotherapy . Thus, these results suggested that APL patients treated with ATO did not appear to have an excess risk of t‐MN.…”

Evaluation of COVID 19 infection in 279 cancer patients treated during a 90-day period in 2020 pandemic

“…One of them was relapsed before the epidemic began, it was resistant to therapy, and the patient died due to leukostasis. There were three cases of M3 Acute Promyelocytic leukemia which are receiving Arsenic and do not have any particular problems [11]. We had 12 cases of myeloma in this 90-day period.…”

Mechanisms of arsenic toxicity and transport in microorganisms

“…Seweryn Mucha 1, 2 , Mateusz Berezowski 1, 2 , Katarzyna Markowska 1 * (Cephalon) stosowanego w leczeniu ostrej białaczki promielocytowej (APL -Acute Promyelocytic Leukemia) [3,27]. Aktualnie prowadzonych jest lub zakończono szereg badań klinicznych nad użytecznością arszeniku w leczeniu innych nowotworów krwi, jak również guzów litych [1,74].…”

“…Związek ten posiada konformację podobną do glicerolu, dlatego też u wszystkich organizmów wnika do wnętrza komórki zgodnie z gradientem stężeń przez akwagliceroporyny. U bakterii Escherichia coli kanałem glicerolowym umożliwiającym przenikanie As(OH) 3 [56,95]. Badania wskazują również, że za akumulację kwasu arsenowego w komórkach S. cerevisiae może być także odpowiedzialny białkowy kompleks Fet3-Ftr1, umożliwiający transport żelaza [6].…”