title: Use of arsenic trioxide in a hemodialysis-dependent patient with relapsed acute promyelocytic leukemia.
abstract: Arsenic trioxide has been established for use in both relapsed and front-line treatment of acute promyelocytic leukemia. Dose adjustments are recommended to be considered in severe renal impairment although dosage reduction guidelines are not provided. In addition, toxicities of arsenic are significant. The use of arsenic trioxide has not been well studied in dialysis patients and there is a paucity of data in the literature to support the use in such a situation. We describe an 81-year-old relapsed acute promyelocytic leukemia hemodialysis-dependent patient with a pre-existing cardiac condition who was treated with 10 mg arsenic trioxide three times weekly after dialysis. These findings provide support along with the marginal amount of currently published data for an arsenic trioxide dosing regimen in hemodialysis patients.
authors.affiliation: Department of Pharmacy, Yale New Haven Hospital, New Haven, CT, USA Sarah.Perreault@ynhh.org.
authors.forename: Sarah
authors.initials: S
authors.lastname: Perreault
authors.affiliation: Department of Pharmacy, Yale New Haven Hospital, New Haven, CT, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Moeller
authors.affiliation: Department of Pharmacy, Yale New Haven Hospital, New Haven, CT, USA.
authors.forename: Kejal
authors.initials: K
authors.lastname: Patel
authors.affiliation: University of Connecticut, School of Pharmacy, Storrs, CT, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Eyler
authors.affiliation: University of Connecticut, School of Pharmacy, Storrs, CT, USA.
authors.forename: Trinh
authors.initials: T
authors.lastname: Pham
authors.affiliation: Department of Cardiovascular and Metabolism, Novartis Institutes for BioMedical Research, Inc., Cambridge, MA, USA.
authors.forename: Kerry
authors.initials: K
authors.lastname: Russell
authors.affiliation: Department of Internal Medicine, Hematology Section, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Nikolai
authors.initials: N
authors.lastname: Podoltsev
mesh_terms: D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D016903:Drug Monitoring; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications / Q000188:drug therapy*; D008297:Male; D010087:Oxides / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D006435:Renal Dialysis
chemical_list: D000970:Antineoplastic Agents; D001152:Arsenicals; D010087:Oxides; D000077237:Arsenic Trioxide
keywords: Arsenic trioxide; acute promyelocytic leukemia; hemodialysis