What are the possible adverse effects of arsenic trioxide (ATO) in the treatment of acute promyelocytic leukemia (APL)?

Updated: May 03, 2019
  • Author: Sandy D Kotiah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

ATO is well tolerated in elderly persons and has antileukemic effects at low doses. Adverse effects of ATO include the following [36] :

  • Prolongation of the QTc interval
  • Hepatotoxicity
  • Nausea and vomiting
  • Fluid retention
  • Itching and rash
  • APL differentiation syndrome

Gemtuzumab ozogamicin, a humanized anti-CD33 antibody linked to an antitumor antibiotic, [37] was approved in May 2000 for first recurrence of AML but was withdrawn from the US market in June 2010 when no improvement in clinical benefit was observed and after a greater number of deaths occurred in the group of patients who received gemtuzumab compared with those receiving chemotherapy alone. In addition, the rate of veno-occlusive disease was shown to be increased in the postmarket setting. Gemtuzumab ozogamicin had been highly effective in molecular or overt relapsed APL. [38, 39]


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