Arsenic trioxide - An old drug rediscovered.

Arsenic trioxide - An old drug rediscovered.
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DOI:
10.1016/j.blre.2010.04.001
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发表时间:
2010-07
期刊:
影响因子:
7.4
通讯作者:
Gore SD
Gore SD
中科院分区:
医学1区
文献类型:
--
作者:
Emadi A;Gore SD

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过去17年来,全球范围内进行的临床试验已经证明了三氧化二砷(As2O3)在治疗复发性急性早幼粒细胞白血病(APL)方面的功效。目前,As2O3 在一线治疗中的作用正在研究中。美国最近的试验表明,在标准治疗方案中添加 As2O3 可改善 APL 患者的生存结果,并可能减少细胞毒性化疗暴露。 As2O3 还显示出对其他恶性肿瘤的疗效,特别是多发性骨髓瘤和骨髓增生异常综合征。 As2O3 的治疗剂量耐受性良好,没有长期毒性的证据。不良事件包括APL分化综合征、心电图异常和肝酶轻度升高。本综述重点介绍了研究 As2O3 在新诊断 APL 的诱导和巩固中的作用及其在其他血液恶性肿瘤中的作用的试验。还讨论了 As2O3 的化学性质、作用机制和临床副作用。
Over the last 17 years, clinical trials conducted worldwide have demonstrated the efficacy of arsenic trioxide (As2O3) in the treatment of relapsed acute promyelocytic leukemia (APL). Currently, the role of As2O3 in front-line therapy is under investigation. Recent trials in the US have demonstrated that the addition of As2O3 to standard treatment regimens improves survival outcomes in patients with APL and may allow a reduction in cytotoxic chemotherapy exposure. As2O3 has also shown efficacy in other malignancies, particularly multiple myeloma and myelodysplastic syndromes. Therapeutic doses of As2O3 are well tolerated, with no evidence of long-term toxicity. Adverse events include APL differentiation syndrome, electrocardiographic abnormalities, and mild elevations in liver enzymes. This review highlights trials investigating the role of As2O3 in induction and consolidation for newly diagnosed APL, as well as its role in other hematologic malignancies. The chemistry, mechanisms of action, and clinical side effects of As2O3 are also discussed.
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