title: [Successful treatment of relapsed and refractory acute promyelocytic leukemia with arsenic trioxide (As2O3)].
abstract: It has been shown that arsenic trioxide (As2O3) may induce hematologic remissions in patients with acute promyelocytic leukemia (APL) refractory to all-trans retinoic acid (ATRA). We reported on a patient with ATRA and drug-resistant APL that was successfully treated with As2O3. The patient had been given a diagnosis of typical APL and was treated with ATRA and chemotherapy for 12 months. He achieved complete remission (CR), but leukemia relapsed with 43% APL cells in the bone marrow in the 16th month of treatment. ATRA and cytarabine plus daunorubicin were administered; however, the APL cells in the bone marrow increased to 97.2%. As2O3 was initiated intravenously, and bone marrow showed a decrease of APL cells (6.7%) and a partial differentiation after 9 days. The patient received idarubicin (IDA) and steroid pulse because of the development of ATRA-like syndrome, and achieved CR 37 days after the initiation of As2O3. He received an additional 2 courses of As2O3 with IDA, and is in CR. These results demonstrated the therapeutic efficacy of As2O3 in treating ATRA and drug-resistant APL.
authors.affiliation: Department of Hematology, Tenri Hospital.
authors.forename: Y
authors.initials: Y
authors.lastname: Tanaka
authors.forename: H
authors.initials: H
authors.lastname: Komatsu
authors.forename: K
authors.initials: K
authors.lastname: Ishii
authors.forename: F
authors.initials: F
authors.lastname: Nakamura
authors.forename: T
authors.initials: T
authors.lastname: Hayashi
authors.forename: H
authors.initials: H
authors.lastname: Sawada
authors.forename: Y
authors.initials: Y
authors.lastname: Ono
authors.forename: T
authors.initials: T
authors.lastname: Imanaka
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000009:adverse effects / Q000627:therapeutic use*; D019008:Drug Resistance, Neoplasm; D006801:Humans; D015255:Idarubicin / Q000627:therapeutic use; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local; D010087:Oxides / Q000009:adverse effects / Q000627:therapeutic use*; D010996:Pleural Effusion / Q000139:chemically induced / Q000188:drug therapy; D012074:Remission Induction; D016896:Treatment Outcome; D014212:Tretinoin / Q000494:pharmacology
chemical_list: D000970:Antineoplastic Agents; D001152:Arsenicals; D010087:Oxides; D014212:Tretinoin; D000077237:Arsenic Trioxide; D015255:Idarubicin