Agis H, Weltermann A, Mitterbauer G, Thalhammer R, Edelhäuser M, Seewann H L, Valent P, Lechner K, Fonatsch C, Geissler K
University of Vienna, Department of Internal Medicine I, Austria.
Ann Hematol. 1999 Jul;78(7):329-32. doi: 10.1007/s002770050523.
Arsenic trioxide has recently been introduced as a promising new agent to treat refractory acute promyelocytic leukemia (APL). In the present study, arsenic trioxide was given intravenously for 42 days to a 56-year-old female patient suffering from chemotherapy/ATRA-resistant APL, with 43% APL blasts in the bone marrow and elevated D-dimers. During the first days of arsenic trioxide treatment a rapid decrease in the D-dimers was seen (normal values reached until day 7), together with a slight decrease in peripheral blood leukocytes. This initial coagulation response was followed by a second phase of hematological response (starting on days 15-20) characterized by leukocytosis, occurrence of myeloid progenitor cells in the peripheral blood, and a decrease in bone marrow blasts (<1% on days 28 and 36). Finally, the patient entered complete hematological and cytogenetic remission, although the PML-RAR alpha fusion product was still detectable by PCR. These data confirm the therapeutic value of arsenic trioxide in relapsed/resistant APL.
三氧化二砷最近被作为一种有前景的新型药物引入，用于治疗难治性急性早幼粒细胞白血病（APL）。在本研究中，对一名56岁患有化疗/全反式维甲酸（ATRA）耐药性APL的女性患者静脉注射三氧化二砷42天，该患者骨髓中APL原始细胞占43%，D-二聚体升高。在三氧化二砷治疗的最初几天，D-二聚体迅速下降（到第7天达到正常值），同时外周血白细胞略有下降。这种初始的凝血反应之后是血液学反应的第二阶段（从第15 - 20天开始），其特征为白细胞增多、外周血中出现髓系祖细胞以及骨髓原始细胞减少（第28天和第36天<1%）。最后，患者进入完全血液学和细胞遗传学缓解期，尽管通过聚合酶链反应（PCR）仍可检测到早幼粒细胞白血病/维甲酸受体α（PML-RARα）融合产物。这些数据证实了三氧化二砷在复发/耐药性APL中的治疗价值。
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