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Cited by 494

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Use of arsenic trioxide (As2O3) in the treatment of patients with acute promyelocytic leukemia: The M. D. Anderson experience

Lazo, Guillermo, Kantarjian, Hagop, Estey, Elihu, Thomas, Deborah, O'Brien, Susan, Cortes, Jorge·2003·Cancer

Abstract

BACKGROUND: Approximately 20–30% of patients with acute promyelocytic leukemia (APL) who are treated with all‐trans retinoic acid (ATRA) and an anthracycline develop recurrent disease. It has been reported that arsenic trioxide (As 2 O 3) is effective in this setting. The authors report the experience of The M. D. Anderson Cancer Center with As 2 O 3 in the treatment of patients with recurrent APL. METHODS: Twelve patients who developed recurrent APL after treatment with ATRA were included. Patients received intravenous As 2 O 3 0.15 mg/kg per day until they achieved a complete remission (CR) or up to a maximum of 60 days. Their median age was 44 years (range, 26–72 years), and the median duration of first remission was 52 weeks (range, 23–292 weeks). RESULTS: All 12 patients achieved a CR. The median time to achieve CR was 52 days (range, 27–75 days). Seven of 10 evaluable patients achieved a molecular remission (i.e., polymerase chain reaction [PCR] analysis was negative for the gene encoding fusion of the nuclear receptor for retinoic acid to the PML gene at the time of CR; 70% of patients; 95% confidence interval, 0.35–0.93), and all other patients had negative PCR results after they received postremission therapy. All patients received subsequent therapy: Four patients received As 2 O 3 alone, six patients received As 2 O 3 with other chemotherapeutic agents, and two patients received idarubicin plus ATRA without As 2 O 3. Eight patients continued in CR after a median follow‐up of 24 months (range, 9–45 months). Side effects were mild, except for two patients who developed Grade 2 and 3 peripheral neuropathy, respectively; one of those patients required discontinuation of therapy. CONCLUSIONS: As 2 O 3 is effective and well tolerated therapy for patients with recurrent APL. Molecular remission may be achieved at the time of CR in the majority of patients, and remissions are durable. Cancer 2003;97:2218–24. © 2003 American Cancer Society. DOI 10.1002/cncr.11314

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Metadata

Authors
Lazo, G., Kantarjian, H., Estey, E., Thomas, D., O'Brien, S., & Cortes, J.
Venue
Cancer
Publisher
Wiley
Published
2003-04-17
Volume
97
Issue
9
Pages
2218-2224
ISSN
  • 0008-543X (ISSN-L)
  • 1097-0142
OpenAlex
W1692919389
Cited by
494
References
28
FWCI
12.55
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Use of arsenic trioxide (As2O3) in the treatment of patients with acute promyelocytic leukemia: The M. D. Anderson experience. https://app.cochat.ai/papers/10.1002/cncr.11314
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Lazo, G., Kantarjian, H., Estey, E., Thomas, D., O'Brien, S., & Cortes, J. (2003). Use of arsenic trioxide (As2O3) in the treatment of patients with acute promyelocytic leukemia: The M. D. Anderson experience. Cancer. https://doi.org/10.1002/cncr.11314

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