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Related Collections Clinical Trials and Observations Related Letter in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, Vol. 94 No. 10 (November 15), 1999: pp. 3315-3324 Studies on Treatment of Acute Promyelocytic Leukemia With Arsenic Trioxide: Remission Induction, Follow-Up, and Molecular Monitoring in 11 Newly Diagnosed and 47 Relapsed Acute Promyelocytic Leukemia Patients Chao Niu, Hua Yan, Ting Yu, Hui-Ping Sun, Jian-Xiang Liu, Xiu-Song Li, Wen Wu, Fen-Qin Zhang, Yu Chen, Li Zhou, Jun-Min Li, Xiao-Ying Zeng, Ren-Rong Ou Yang, Mi-Man Yuan, Mei-Yu Ren, Feng-Ying Gu, Qi Cao, Bo-Wei Gu, Xin-Ying Su, Guo-Qiang Chen, Shu-Min Xiong, Ting-dong Zhang, Samuel Waxman, Zhen-Yi Wang, Zhu Chen, Jiong Hu, Zhi-Xiang Shen, and Sai-Juan Chen From Shanghai Institute of Hematology, Department of Hematology/Oncology, Rui Jin Hospital/Samuel Waxman Cancer Research Foundation Joint Center for Cancer Differentiation Therapy Sponsored by Reliance Group Holdings Inc, Rui-Jin Hospital, Ren-Ji Hospital; Xin-Hua Hospital, Shanghai Second Medical University, Shanghai, China; Zhong-Shan Hospital, Shanghai, China; Gan-Quan Hospital, Shanghai, China; and First Hospital Affiliated with Harbin Medical University, Harbin, China. Fifty-eight acute promyelocytic leukemia (APL) patients (11 newly diagnosed and 47 relapsed) were studied for arsenic trioxide (As2O3) treatment. Clinical complete remission (CR) was obtained in 8 of 11 (72.7%) newly diagnosed cases. However, As2O3 treatment resulted in hepatic toxicity in 7 cases including 2 deaths, in contrast to the mild liver dysfunction in one third of the relapsed patients. Forty of forty-seven (85.1%) relapsed patients achieved CR. Two of three nonresponders showed clonal evolution at relapse, with disappearance of t(15;17) and PML-RAR fusion gene in 1 and shift to a dominant AML-1-ETO population in another, suggesting a correlation between PML-RAR expression and therapeutic response. In a follow-up of 33 relapsed cases over 7 to 48 months, the estimated disease-free survival (DFS) rates for 1 and 2 years were 63.6% and 41.6%, respectively, and the actual median DFS was 17 months. Patients with white blood cell (WBC) count below 10 × 109/L at relapse had better survival than those with WBC count over 10 × 109/L (P = .038). The duration of As2O3-induced CR was related to postremission therapy, because there was only 2 of 11 relapses in patients treated with As2O3 combined with chemotherapy, compared with 12 of 18 relapses with As2O3 alone (P = .01). Reverse transcription polymerase chain reaction (RT-PCR) analysis in both newly diagnosed and relapsed groups showed long-term use of As2O3 could lead to a molecular remission in some patients. We thus recommend that ATRA be used as first choice for remission induction in newly diagnosed APL cases, whereas As2O3 can be either used as a rescue for relapsed cases or included into multidrug consolidation/maintenance clinical trials. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? 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Kwong Oral arsenic trioxide in the treatment of relapsed acute promyelocytic leukemia Blood, July 1, 2003; 102(1): 407 - 408. [Full Text] [PDF] E. Raffoux, P. Rousselot, J. Poupon, M.-T. Daniel, B. Cassinat, R. Delarue, A.-L. Taksin, D. Rea, A. Buzyn, A. Tibi, et al. Combined Treatment With Arsenic Trioxide and All-Trans-Retinoic Acid in Patients With Relapsed Acute Promyelocytic Leukemia J. Clin. Oncol., June 15, 2003; 21(12): 2326 - 2334. [Abstract] [Full Text] [PDF] Y. Zhou, E. O. Hileman, W. Plunkett, M. J. Keating, and P. Huang Free radical stress in chronic lymphocytic leukemia cells and its role in cellular sensitivity to ROS-generating anticancer agents Blood, May 15, 2003; 101(10): 4098 - 4104. [Abstract] [Full Text] [PDF] W. Y. Au, A. K. W. Lie, C. S. Chim, R. Liang, S. K. Ma, C. H. Chan, Y. K. Mak, Y. T. Chen, C. C. So, Y. M. Yeung, et al. Arsenic trioxide in comparison with chemotherapy and bone marrow transplantation for the treatment of relapsed acute promyelocytic leukaemia Ann. Onc., May 1, 2003; 14(5): 752 - 757. [Abstract] [Full Text] [PDF] G.-Q. Chen, L. Zhou, M. Styblo, F. Walton, Y. Jing, R. Weinberg, Z. Chen, and S. Waxman Methylated Metabolites of Arsenic Trioxide Are More Potent Than Arsenic Trioxide as Apoptotic but not Differentiation Inducers in Leukemia and Lymphoma Cells Cancer Res., April 15, 2003; 63(8): 1853 - 1859. [Abstract] [Full Text] [PDF] Z.-y. Wang Ham-Wasserman Lecture: Treatment of Acute Leukemia by Inducing Differentiation and Apoptosis Hematology, January 1, 2003; 2003(1): 1 - 13. [Abstract] [Full Text] [PDF] B. Lowenberg, J. D. Griffin, and M. S. Tallman Acute Myeloid Leukemia and Acute Promyelocytic Leukemia Hematology, January 1, 2003; 2003(1): 82 - 101. [Abstract] [Full Text] [PDF] M. S. Tallman, J. W. Andersen, C. A. Schiffer, F. R. Appelbaum, J. H. Feusner, W. G. Woods, A. Ogden, H. Weinstein, L. Shepherd, C. Willman, et al. All-trans retinoic acid in acute promyelocytic leukemia: long-term outcome and prognostic factor analysis from the North American Intergroup protocol Blood, December 15, 2002; 100(13): 4298 - 4302. [Abstract] [Full Text] [PDF] C.-E. Chiang, H.-N. Luk, T.-M. Wang, and P. Y.-A. Ding Prolongation of cardiac repolarization by arsenic trioxide Blood, August 28, 2002; 100(6): 2249 - 2252. [Abstract] [Full Text] [PDF] Y. Jing, L. Xia, and S. Waxman Targeted removal of PML-RARalpha protein is required prior to inhibition of histone deacetylase for overcoming all-trans retinoic acid differentiation resistance in acute promyelocytic leukemia Blood, July 18, 2002; 100(3): 1008 - 1013. [Abstract] [Full Text] [PDF] W. H. Miller Jr., H. M. Schipper, J. S. Lee, J. Singer, and S. Waxman Mechanisms of Action of Arsenic Trioxide Cancer Res., July 15, 2002; 62(14): 3893 - 3903. [Abstract] [Full Text] [PDF] D.-P. Lu, J.-Y. Qiu, B. Jiang, Q. Wang, K.-Y. Liu, Y.-R. Liu, and S.-S. Chen Tetra-arsenic tetra-sulfide for the treatment of acute promyelocytic leukemia: a pilot report Blood, May 1, 2002; 99(9): 3136 - 3143. [Abstract] [Full Text] [PDF] Z. Liu, J. Shen, J. M. Carbrey, R. Mukhopadhyay, P. Agre, and B. P. Rosen Arsenite transport by mammalian aquaglyceroporins AQP7 and AQP9 PNAS, April 18, 2002; (2002) 92131899. [Abstract] [Full Text] [PDF] J. L. Slack, S. Waxman, G. Tricot, M. S. Tallman, and C. D. Bloomfield Advances in the Management of Acute Promyelocytic Leukemia and Other Hematologic Malignancies with Arsenic Trioxide Oncologist, April 1, 2002; 7(90001): 1 - 13. [Abstract] [Full Text] [PDF] M. S. Tallman, C. Nabhan, J. H. Feusner, and J. M. Rowe Acute promyelocytic leukemia: evolving therapeutic strategies Blood, February 1, 2002; 99(3): 759 - 767. [Abstract] [Full Text] [PDF] W. Y. Au, G. C.F. Chan, C. S. Chim, T. W. Shek, G. C. Ooi, W. K. Ho, and Y. L. Kwong Unusual Sites of Involvement by Hematologic Malignancies: Case 3. External Auditory Canal Tumor: A Rare Chloroma in Acute Promyelocytic Leukemia With a Complete Response to Arsenic Trioxide J. Clin. Oncol., October 1, 2001; 19(19): 3993 - 3995. [Full Text] D. E. Epner Can Dietary Methionine Restriction Increase the Effectiveness of Chemotherapy in Treatment of Advanced Cancer? J. Am. Coll. Nutr., October 1, 2001; 20(90005): 443S - 449. [Abstract] [Full Text] E. Briasoulis and N. Pavlidis Noncardiogenic Pulmonary Edema: An Unusual and Serious Complication of Anticancer Therapy Oncologist, April 1, 2001; 6(2): 153 - 161. [Abstract] [Full Text] S. Waxman and K. C. Anderson History of the Development of Arsenic Derivatives in Cancer Therapy Oncologist, April 1, 2001; 6(90002): 3 - 10. [Abstract] [Full Text] S. L. Soignet Clinical Experience of Arsenic Trioxide in Relapsed Acute Promyelocytic Leukemia Oncologist, April 1, 2001; 6(90002): 11 - 16. [Abstract] [Full Text] D. Unnikrishnan, J. P. Dutcher, N. Varshneya, R. Lucariello, M. Api, S. Garl, P. H. Wiernik, and S. Chiaramida Torsades de pointes in 3 patients with leukemia treated with arsenic trioxide Blood, March 1, 2001; 97(5): 1514 - 1516. [Abstract] [Full Text] [PDF] Y. Jing, L. Wang, L. Xia, G.-q. Chen, Z. Chen, W. H. Miller, and S. Waxman Combined effect of all-trans retinoic acid and arsenic trioxide in acute promyelocytic leukemia cells in vitro and in vivo Blood, January 1, 2001; 97(1): 264 - 269. [Abstract] [Full Text] [PDF] K. Ohnishi, H. Yoshida, K. Shigeno, S. Nakamura, S. Fujisawa, K. Naito, K. Shinjo, Y. Fujita, H. Matsui, A. Takeshita, et al. Prolongation of the QT Interval and Ventricular Tachycardia in Patients Treated with Arsenic Trioxide for Acute Promyelocytic Leukemia Ann Intern Med, December 5, 2000; 133(11): 881 - 885. [Abstract] [Full Text] [PDF] O. Bruserud, B. T. Gjertsen, and T.-s. Huang Induction of Differentiation and Apoptosis-- A Possible Strategy in the Treatment of Adult Acute Myelogenous Leukemia Oncologist, December 1, 2000; 5(6): 454 - 462. [Abstract] [Full Text] T. F. Roberts, K. Sprague, D. Schenkein, K. B. Miller, and V. Relias Hyperleukocytosis during induction therapy with arsenic trioxide for relapsed acute promyelocytic leukemia associated with central nervous system infarction Blood, December 1, 2000; 96(12): 4000 - 4001. [Full Text] [PDF] M. J. McCabe Jr., K. P. Singh, S. A. Reddy, B. Chelladurai, J. G. Pounds, J. J. Reiners Jr., and J. C. States Sensitivity of Myelomonocytic Leukemia Cells to Arsenite-Induced Cell Cycle Disruption, Apoptosis, and Enhanced Differentiation Is Dependent on the Inter-Relationship between Arsenic Concentration, Duration of Treatment, and Cell Cycle Phase J. Pharmacol. Exp. Ther., November 1, 2000; 295(2): 724 - 733. [Abstract] [Full Text] W. Y. Au, S. K. Ma, C. Ooi, R. Liang, and Y. L. Kwong Unusual Manifestations of Acute Leukemia J. Clin. Oncol., October 19, 2000; 18(19): 3435 - 3437. [Full Text] [PDF] Z. Liu, J. Shen, J. M. Carbrey, R. Mukhopadhyay, P. Agre, and B. P. Rosen Arsenite transport by mammalian aquaglyceroporins AQP7 and AQP9 PNAS, April 30, 2002; 99(9): 6053 - 6058. [Abstract] [Full Text] [PDF]

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