The Use of Arsenic Trioxide in Acute Promyelocytic Leukemia

May 29, 2013
Francesco Lo-Coco, MD

Francesco Lo-Coco, MD, Hematology, University Tor Vergata, speaks at the 2012 American Society of Hematology annual meeting about the use of arsenic trioxide in acute promyelocytic leukemia.

Francesco Lo-Coco, MD, Hematology, University Tor Vergata, speaks at the 2012 American Society of Hematology annual meeting about the use of arsenic trioxide (ATO) in acute promyelocytic leukemia (APL).

Currently, all-trans retinoic acid (ATRA) plus chemotherapy is the gold standard for newly diagnosed APL patients demonstrating an 80% cure rate and typical toxicities (myelosuppression infections, hair loss). In the past 10 to 15 years, Lo-Coco says, ATO was suggested by Chinese investigators to show efficacy in APL with inferior toxicity.

Clinical Pearls

A phase III trial analyzing ATRA and ATO versus ATRA and idarubicin (AIDA) in newly diagnosed, non high-risk APL showed that the new strategy is at least equally effective.

  • All-trans retinoic acid (ATRA) plus chemotherapy is the gold standard for newly diagnosed APL patients
  • Arsenic trioxide has demonstrated efficacy in APL with inferior toxicity to ATRA