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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.


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Submitted September 1, 2005
Accepted November 24, 2005

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, Poonkuzhi Balasubramaniam, Ramachandran V Shaji, Vivi M Srivastava, Alok Srivastava, and Mammen Chandy

Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India

* Corresponding author; email: vikram{at}cmcvellore.ac.in.

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 hematological remission was achieved in 86.1%. At a median follow up of 25 months (range: 8 to 92), 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 WBC count <5 x 109/lt and a Platelet count >20 x 109/lt 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. Post remission induction, this regimen, was administered on an out patient basis. Single agent As2O3, as used in this series, in the management of newly diagnosed cases of APL, is associated with responses comparable to conventional chemotherapy regimens. Additionally, this regimen has minimal toxicity and can be administered on an outpatient basis.


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