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Blood, 1 April 2006, Vol. 107, No. 7, pp. 2627-2632. Prepublished online as a Blood First Edition Paper on December 13, 2005; DOI 10.1182/blood-2005-08-3532. This Article Full Text Full Text (PDF) All Versions of this Article: 2005-08-3532v1 107/7/2627    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Mathews, V. Articles by Chandy, M. Search for Related Content PubMed PubMed Citation Articles by Mathews, V. Articles by Chandy, M. Related Collections Neoplasia Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Single-agent arsenic trioxide in the treatment of newly diagnosed acute promyelocytic leukemia: durable remissions with minimal toxicity Vikram Mathews, Biju George, Kavitha M. Lakshmi, Auro Viswabandya, Ashish Bajel, Poonkuzhali Balasubramanian, Ramachandran Velayudhan Shaji, Vivi M. Srivastava, Alok Srivastava, and Mammen Chandy From the Department of Haematology, Christian Medical College, Vellore, India. Arsenic trioxide, as a single agent, has proven efficacy in inducing molecular remission in patients with acute promyelocytic leukemia (APL). There is limited long-term outcome data with single-agent As2O3 in the management of newly diagnosed cases of APL. Between January 1998 to December 2004, 72 newly diagnosed cases of APL were treated with a regimen of single-agent As2O3 at our center. Complete hematologic remission was achieved in 86.1%. At a median follow-up of 25 months (range: 8-92 months), the 3-year Kaplan-Meier estimate of EFS, DFS, and OS was 74.87% ± 5.6%, 87.21% ± 4.93%, and 86.11% ± 4.08%, respectively. Patients presenting with a white blood cell (WBC) count lower than 5 x 109/L and a platelet count higher than 20 x 109/L at diagnosis (n = 22 [30.6%]) have an excellent prognosis with this regimen (EFS, OS, and DFS of 100%). The toxicity profile, in the majority, was mild and reversible. After remission induction, this regimen was administered on an outpatient basis. Single-agent As2O3, as used in this series, in the management of newly diagnosed cases of APL, is associated with responses comparable with conventional chemotherapy regimens. Additionally, this regimen has minimal toxicity and can be administered on an outpatient basis after remission induction. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: ATO: the forefront of APL treatment? Dan Douer Blood 2006 107: 2588-2589. [Full Text] [PDF] This article has been cited by other articles: D. Grimwade, J. V. Jovanovic, R. K. Hills, E. A. Nugent, Y. Patel, R. Flora, D. Diverio, K. Jones, H. Aslett, E. Batson, et al. Prospective Minimal Residual Disease Monitoring to Predict Relapse of Acute Promyelocytic Leukemia and to Direct Pre-Emptive Arsenic Trioxide Therapy J. Clin. Oncol., August 1, 2009; 27(22): 3650 - 3658. [Abstract] [Full Text] [PDF] C. Kelaidi, S. Chevret, S. De Botton, E. Raffoux, A. Guerci, X. Thomas, A. Pigneux, T. Lamy, F. Rigal-Huguet, S. Meyer-Monard, et al. Improved Outcome of Acute Promyelocytic Leukemia With High WBC Counts Over the Last 15 Years: The European APL Group Experience J. Clin. Oncol., June 1, 2009; 27(16): 2668 - 2676. [Abstract] [Full Text] [PDF] D. Nowak, D. Stewart, and H. P. Koeffler Differentiation therapy of leukemia: 3 decades of development Blood, April 16, 2009; 113(16): 3655 - 3665. [Abstract] [Full Text] [PDF] J. Hu, Y.-F. Liu, C.-F. Wu, F. Xu, Z.-X. Shen, Y.-M. Zhu, J.-M. Li, W. Tang, W.-L. Zhao, W. Wu, et al. Long-term efficacy and safety of all-trans retinoic acid/arsenic trioxide-based therapy in newly diagnosed acute promyelocytic leukemia PNAS, March 3, 2009; 106(9): 3342 - 3347. [Abstract] [Full Text] [PDF] J. D. Licht Acute Promyelocytic Leukemia -- Weapons of Mass Differentiation N. Engl. J. Med., February 26, 2009; 360(9): 928 - 930. [Full Text] [PDF] M. A. Sanz, D. Grimwade, M. S. Tallman, B. Lowenberg, P. Fenaux, E. H. Estey, T. Naoe, E. Lengfelder, T. Buchner, H. Dohner, et al. Management of acute promyelocytic leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet Blood, February 26, 2009; 113(9): 1875 - 1891. [Abstract] [Full Text] [PDF] F. Ravandi, E. Estey, D. Jones, S. Faderl, S. O'Brien, J. Fiorentino, S. Pierce, D. Blamble, Z. Estrov, W. Wierda, et al. Effective Treatment of Acute Promyelocytic Leukemia With All-Trans-Retinoic Acid, Arsenic Trioxide, and Gemtuzumab Ozogamicin J. Clin. Oncol., February 1, 2009; 27(4): 504 - 510. [Abstract] [Full Text] [PDF] A. A. Morales, D. Gutman, K. P. Lee, and L. H. Boise BH3-only proteins Noxa, Bmf, and Bim are necessary for arsenic trioxide-induced cell death in myeloma Blood, May 15, 2008; 111(10): 5152 - 5162. [Abstract] [Full Text] [PDF] Z.-Y. Wang and Z. Chen Acute promyelocytic leukemia: from highly fatal to highly curable Blood, March 1, 2008; 111(5): 2505 - 2515. [Abstract] [Full Text] [PDF] M. S. Tallman and J. K. Altman Curative Strategies in Acute Promyelocytic Leukemia Hematology, January 1, 2008; 2008(1): 391 - 399. [Abstract] [Full Text] [PDF] V. Mathews, M. Thomas, V. M Srivastava, B. George, A. Srivastava, and M. Chandy Impact of FLT3 mutations and secondary cytogenetic changes on the outcome of patients with newly diagnosed acute promyelocytic leukemia treated with a single agent arsenic trioxide regimen Haematologica, July 1, 2007; 92(7): 994 - 995. [Abstract] [Full Text] [PDF] G. S. Dbaibo, Y. Kfoury, N. Darwiche, S. Panjarian, L. Kozhaya, R. Nasr, M. Abdallah, O. Hermine, M. El-Sabban, H. de The, et al. Arsenic trioxide induces accumulation of cytotoxic levels of ceramide in acute promyelocytic leukemia and adult T-cell leukemia/lymphoma cells through de novo ceramide synthesis and inhibition of glucosylceramide synthase activity Haematologica, June 1, 2007; 92(6): 753 - 762. [Abstract] [Full Text] [PDF] F. Lo-Coco, E. Ammatuna, and M. A. Sanz Current treatment of acute promyelocytic leukemia Haematologica, March 1, 2007; 92(3): 289 - 291. [Full Text] [PDF] X. Zheng, A. Seshire, B. Ruster, G. Bug, T. Beissert, E. Puccetti, D. Hoelzer, R. Henschler, and M. Ruthardt Arsenic but not all-trans retinoic acid overcomes the aberrant stem cell capacity of PML/RAR{alpha}-positive leukemic stem cells Haematologica, March 1, 2007; 92(3): 323 - 331. [Abstract] [Full Text] [PDF] M. Brown, M. Bellon, and C. Nicot Emodin and DHA potently increase arsenic trioxide interferon-{alpha}-induced cell death of HTLV-I-transformed cells by generation of reactive oxygen species and inhibition of Akt and AP-1 Blood, February 15, 2007; 109(4): 1653 - 1659. [Abstract] [Full Text] [PDF] L. Ades, S. Chevret, E. Raffoux, S. de Botton, A. Guerci, A. Pigneux, A. M. Stoppa, T. Lamy, F. Rigal-Huguet, A. Vekhoff, et al. Is Cytarabine Useful in the Treatment of Acute Promyelocytic Leukemia? Results of a Randomized Trial From the European Acute Promyelocytic Leukemia Group J. Clin. Oncol., December 20, 2006; 24(36): 5703 - 5710. [Abstract] [Full Text] [PDF] B. Mukherjee, O. E. Salavaggione, L. L. Pelleymounter, I. Moon, B. W. Eckloff, D. J. Schaid, E. D. Wieben, and R. M. Weinshilboum GLUTATHIONE S-TRANSFERASE OMEGA 1 AND OMEGA 2 PHARMACOGENOMICS Drug Metab. Dispos., July 1, 2006; 34(7): 1237 - 1246. [Abstract] [Full Text] [PDF] M. A. Sanz Treatment of Acute Promyelocytic Leukemia Hematology, January 1, 2006; 2006(1): 147 - 155. [Abstract] [Full Text] [PDF]

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