Treatment of acute promyelocytic leukemia with arsenic trioxide without ATRA and/or chemotherapy

Abstract

Arsenic trioxide is effective as first-line treatment for APL. Results of arsenic trioxide combination therapy with chemotherapy/ATRA requires further study.

A novel arsenical has antitumor activity toward As2O3-resistant and MRP1/ABCC1-overexpressing cell lines

“…1 The therapeutic use of As 2 O 3 in APL has recently advanced to first-line therapy, where several reports have described benefit. [2][3][4] The activity of As 2 O 3 in APL is, in part, related to the disappearance of the promyelocytic leukemia (PML)/retinoic acid receptor (RAR)a fusion protein, the gene product of the chromosomal translocation t(15,17) characteristic of APL, and the induction of differentiation. 5,6 In addition, As 2 O 3 deregulates numerous proteins through binding to sulfhydryl groups, 7 inhibits mitochondrial respiratory function 8 and induces Bax oligomerization, 9 triggering apoptosis in non-APL cell lines.…”

How to manage acute promyelocytic leukemia

“…67 Recent literature supports our data in that the CR rate and EFS were relatively higher in the working groups using ATO/ATRA combination 68,69 compared with the groups using ATO alone. 59,60,62 GIMEMA group carried out a randomized phase III study to compare ATO þ ATRA versus standard ATRA þ anthracycline-based chemotherapy (AIDA regimen) for newly diagnosed non high-risk APL. We are eagerly anticipating their results.…”

“…The common adverse effects are mainly grade I --II hepatotoxicity, gastrointestinal reactions, neurotoxicity and very rarely, grade III --IV hepatotoxicity, which are usually reversible. 59,60 Thus, in clinical practice, we recommend administration of some therapeutic agents (for example, Diammonium Glycyrrizinate, a drug based on the Traditional Chinese Medicine; Polyene Phosphatidylcholine) to prevent liver damage.…”

Preparation, characterization, in vivo and in vitro studies of arsenic trioxide Mg-Fe ferrite magnetic nanoparticles

“…Despite the toxicity of arsenic, ATO has long been of biomedical interest. Recently, it has been shown to be efficient in the treatment of newly diagnosed and relapsed acute promyelocytic leukemia [2][3][4][5] . More interestingly, this anticancer efficiency of ATO was extended to many solid tumors [6,7] , and ATO has been shown to induce apoptosis in various malignant tumor cells [8,9] .…”