https://scholars.lib.ntu.edu.tw/handle/123456789/495161
標題: | Arsenic trioxide therapy for relapsed acute promyelocytic leukemia: An useful salvage therapy | 作者: | SHANG-YI HUANG CHIH-HSIN YANG YAO-CHANG CHEN |
公開日期: | 2000 | 出版社: | Harwood Academic Publishers GmbH | 卷: | 38 | 期: | 3��4�� | 起(迄)頁: | 283-293 | 來源出版物: | Leukemia and Lymphoma | 摘要: | Arsenic trioxide (As2O3) was recently identified as a very potent agent against acute promyelocytic leukemia (APL). Intravenous infusion of 10 mg As2O3 daily for one to two months can induce significant complete remission (CR) of APL, and there is no cross drug-resistance between As2O3 and other antileukemic agents, including all-trans retinoic acid (ATRA). The CR rate of relapsed and/or refractory APL patients who received As2O3 treatment ranged from 52.3% to 93.3%. The median duration to CR ranged from 38 to 51 days, with accumulative As2O3 dosage of 340-430 mg. Although most adverse reactions of As2O3 treatment were tolerable, certain infrequent but severe toxicities related to As2O3 were observed, including renal failure, hepatic damage, cardiac arrhythmia and chronic neuromuscular degeneration, which should be monitored carefully. As2O3 can induce partial differentiation and subsequent apoptosis of APL cells through degradation of wild type PML and PML/RAR α chimeric proteins and possible anti-mitochondrial effects. Like the treatment of ATRA in APL, early relapses from As2O3 treatment within a few months were not infrequently seen, indicating that rapid emerging resistance to As2O3 can occur. Nevertheless, the PML/RAR α fusion protein was reported to disappear in some APL patients who received As2O3, and who might earn long-survival. However, the follow-up is still too short to draw the conclusion. Intriguingly, it has been shown that As2O3 can also induce apoptosis of other non-APL tumor cells with clinical achievable concentrations. However, the detailed molecular mechanisms are not yet fully understood. Further studies regarding to the pharmacological characters, clinical efficacies, toxicities, apoptogenic mechanisms, and spectrum of anti-tumor activity of As2O3 are warranted. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0034123033&doi=10.3109%2f10428190009087019&partnerID=40&md5=7effa293ba44c0401f2387b544d66f68 https://scholars.lib.ntu.edu.tw/handle/123456789/495161 |
ISSN: | 1042-8194 | DOI: | 10.3109/10428190009087019 | SDG/關鍵字: | antileukemic agent; arsenic trioxide; chimeric protein; retinoic acid; acute myeloblastic leukemia; apoptosis; article; cancer survival; cell differentiation; cross resistance; degenerative disease; drug accumulation; drug potency; drug tolerability; fluid retention; heart arrhythmia; human; kidney failure; liver toxicity; muscle atrophy; neuromuscular disease; paresthesia; priority journal; relapse; salvage therapy; side effect; skin toxicity |
顯示於: | 腫瘤醫學研究所 |
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