What is the best treatment for acute promyelocytic leukemia?
Most cases of APL are treated with an anthracycline chemotherapy drug (daunorubicin or idarubicin) plus the non-chemotherapy drug, all-trans-retinoic acid (ATRA), which is a relative of vitamin A. This treatment leads to remission in 80% to 90% of patients.
Is arsenic used to treat leukemia?
Recently, a single dose of arsenic trioxide (As2O3) has been found especially effective in treating acute promyelocytic leukemia (APL). Generally speaking, As2O3 is a more effective treatment of APL than other, newer medications and has less severe adverse reactions and greater safety.
What is the indication for the differentiating agent arsenic trioxide?
TRISENOX is indicated for induction of remission and consolidation in patients with APL who are refractory to, or have relapsed from, retinoid and anthracycline chemotherapy, and whose APL is characterized by the presence of the t(15;17) translocation or PML/RAR-alpha gene expression.
How is arsenic trioxide administered?
Arsenic trioxide comes as a solution (liquid) to be injected into a vein by a doctor or nurse in a medical office or clinic. Arsenic trioxide is usually injected over 1 to 2 hours, but it may be injected over as long as 4 hours if side effects are experienced during the infusion.
How is acute promyelocytic leukemia ( APL ) treated?
Acute promyelocytic leukemia (APL) has become a highly curable disease with contemporary treatment, which consists of all-trans retinoic acid (ATRA) and anthracycline-based chemotherapy.
How is retinoic acid used to treat promyelocytic leukemia?
All- trans retinoic acid (ATRA) with chemotherapy is the standard of care for acute promyelocytic leukemia (APL), resulting in cure rates exceeding 80%. Pilot studies of treatment with arsenic trioxide with or without ATRA have shown high efficacy and reduced hematologic toxicity.
Which is better for promyelocytic ATRA or arsenic trioxide?
Two-year event-free survival rates were 97% in the ATRA–arsenic trioxide group and 86% in the ATRA–chemotherapy group (95% confidence interval for the difference, 2 to 22 percentage points; P<0.001 for noninferiority and P=0.02 for superiority of ATRA–arsenic trioxide). Overall survival was also better with ATRA–arsenic trioxide (P=0.02).
What are the survival rates for arsenic trioxide?
Two-year event-free survival rates were 97% in the ATRA–arsenic trioxide group and 86% in the ATRA–chemotherapy group (95% confidence interval for the difference, 2 to 22 percentage points; P<0.001 for noninferiority and P=0.02 for superiority of ATRA–arsenic trioxide).
