Au Wing-Yan, Kumana Cyrus R, Lam Ching-Wan, Cheng Vincent C C, Shek Tony W, Chan Eric Y T, Liu Rico, Kwong Yok-Lam
Department of Medicine, Professorial Block, Queen Mary Hospital, Pokfulam Road, Hong Kong.
Leuk Res. 2007 Jan;31(1):105-8. doi: 10.1016/j.leukres.2006.03.018. Epub 2006 May 24.
Arsenic trioxide (As(2)O(3)) is highly efficacious for acute promyelocytic leukemia (APL). Environmental arsenic exposure predisposes to malignancies, but the risk for therapeutic arsenic is undefined. Three APL patients (de novo, 2; therapy-related, 1) in a cohort of 59 cases given oral-As(2)O(3) for induction and maintenance treatment developed secondary cancers (nasopharyngeal carcinoma, 2; colonic adenocarcinoma, 1) at 16, 36 and 55 months post-As(2)O(3) therapy. Retrospective analysis of biomarkers (Epstein Barr virus serology and quantification, carcinoembryonic antigen) showed the potential presence of cancers before or shortly after As(2)O(3) therapy, suggesting that As(2)O(3) had not initiated these malignancies. Compared against matched background population, there was an increased risk of second cancer (p=0.012, standard incidence ratio=6.5; 95% confidence interval=1.4-19.0).
三氧化二砷（As₂O₃）对急性早幼粒细胞白血病（APL）疗效显著。环境砷暴露易引发恶性肿瘤，但治疗用砷的风险尚不明确。在一组59例接受口服As₂O₃进行诱导和维持治疗的患者中，有3例APL患者（2例初发，1例治疗相关）在As₂O₃治疗后16、36和55个月发生了继发性癌症（2例鼻咽癌，1例结肠腺癌）。对生物标志物（爱泼斯坦 - 巴尔病毒血清学及定量、癌胚抗原）的回顾性分析显示，在As₂O₃治疗前或治疗后不久可能已存在癌症，这表明As₂O₃并非引发这些恶性肿瘤的原因。与匹配的背景人群相比，二次癌症风险增加（p = 0.012，标准化发病率比 = 6.5；95%置信区间 = 1.4 - 19.0）。
