title: Arsenic-induced APL differentiation in cerebrospinal fluid.
abstract: Although new approaches have dramatically improved, the treatment of acute promyelocytic leukemia (APL) involvement of the central nervous system (CNS) confers a bad prognosis in the disease. Here, we report a patient who was diagnosed with relapsed APL preferentially involving the CNS. Treatment with arsenic trioxide led to impressive morphological changes in CNS cellularity consistent with the induction of a differentiation syndrome. Since arsenic trioxide could be identified in the CNS, we provide evidence that the drug can cross the blood-brain barrier and can be used for treatment of extramedullary APL.
authors.affiliation: Medical Clinic and Policlinic I, University Hospital of the Technical University, Fetscherstrasse 74, 01307 Dresden, Germany.
authors.forename: Annett
authors.initials: A
authors.lastname: Helwig
authors.forename: Matthias
authors.initials: M
authors.lastname: Klemm
authors.forename: Reinhard
authors.initials: R
authors.lastname: Schüttig
authors.forename: Christoph
authors.initials: C
authors.lastname: Röllig
authors.forename: Nasstasja
authors.initials: N
authors.lastname: Wassilew
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ehninger
authors.forename: Thomas
authors.initials: T
authors.lastname: Illmer
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D002454:Cell Differentiation; D002555:Cerebrospinal Fluid / Q000166:cytology; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D007962:Leukocytes / Q000473:pathology; D010087:Oxides / Q000627:therapeutic use*; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001152:Arsenicals; D010087:Oxides; D000077237:Arsenic Trioxide