II. Indications
- FDA approved (adults and children age >5 years old)
- Acute Promyelocytic Leukemia (APL, refractory)
- Off-Label
III. Mechanism
- Small-molecule Arsenic-based antineoplastic (As2O3)
- Also used in manufacturing (wood preservatives, Pesticides, and glass)
- Degrades the PML Protein-Retinoic Acid receptor alpha fusion Protein (PML/RARa)
- Inhibits cell proliferation and induces apoptosis of APL cells (as well as other cancer cells)
- Promotes dell differentiation and Angiogenesis
IV. Dosing
- See other references for disease specific dosing protocols
V. Adverse Effects
- APL Differentiation Syndrome
- Presents with fever and Dyspnea
- Signs include Pulmonary Infiltrates, Pleural Effusions, Pericardial Effusions, weight gain, Cardiomyopathy, Hypotension
- EKG Abnormalities
- Gastrointestinal
- Miscellaneous
VI. Safety
- Avoid in Lactation
- Avoid in pregnancy (all trimesters)
- Use reliable Contraception
- Monitoring
VII. Safety
- Avoid in Lactation
- Avoid in pregnancy (all trimesters)
- Use reliable Contraception
VIII. Resources
- Arsenic Trioxide (DailyMed)