Tijdschrift voor geneeskunde vol:62 issue:3 pages:223-234
The importance of arsenic trioxide in the treatment of acute promyelocytic leukemia (APL) is illustrated by the hereby reported clinical case. 20% of the patients relapse after treatment with the standard therapeutic methods, i.e. all-trans retinoic acid (ATRA) and chemotherapy.
Over the last 10 years several studies proved arsenic trioxide to be effective in relapsed acute promyelocytic leukemia, with high complete remission rates. Although the drug is safe in patients who relapsed, severe hepatotoxicity has been observed in some newly diagnosed patients.
The action of mechanism is yet not completely understood, but one assumes that arsenic trioxide induces differentiation and apoptosis in APL cells. Consolidation therapy is needed, as it is after treatment with ATRA; still, the optimal therapy for consolidation remains currently uncertain.
The potentials of arsenic trioxide in the treatment of malignancies other than acute promyelocytic leukemia are under investigation.