Arsenic Trioxide

Indications

Cancer

Arsenic Trioxide (ATO) is an arsenical medicine used in two situations. The first is together with tretinoin, for adults with newly-diagnosed low-risk acute promyelocytic leukemia (APL), where the APL is marked by the t (15;17) translocation or PML/RAR-alpha gene expression. The second is to induce remission and for consolidation in patients with APL who are refractory to retinoid and anthracycline chemotherapy, or who have relapsed after it. Here too, the APL must be marked by the t (15;17) translocation or PML/RAR-alpha gene expression.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Scientists don't fully understand how Arsenic Trioxide works. In laboratory studies on NB4 human promyelocytic leukemia cells, it caused morphological changes and DNA fragmentation that are typical of apoptosis. Arsenic Trioxide also damages or breaks down the fusion protein promyelocytic leukemia (PML)-retinoic acid receptor (RAR)-alpha.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: For newly diagnosed low-risk APL, Arsenic Trioxide is used together with tretinoin. During induction, give 0.15 mg/kg/day intravenously every day until the bone marrow goes into remission. Do not go beyond 60 days. For consolidation, give 0.15 mg/kg/day intravenously for 5 days per week during weeks 1 to 4 of each 8-week cycle, for a total of 4 cycles, again with tretinoin. For relapsed or refractory APL, induction is 0.15 mg/kg/day intravenously every day until bone marrow remission, and this must not exceed 60 days. Consolidation is 0.15 mg/kg/day intravenously for 25 doses over a period of up to 5 weeks.

Side Effects & Interactions

Side Effects

No side-effect data recorded yet.

Key Interactions

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Tretinoin