A Case of Relapsed Acute Promyleocytic Leukemia Induced Remission with Arsenic Trioxide(As2O3)

ABSTRACT

Acute promyelocytic leukemia(APL) is a unique entity in the spectrum of acute myelogenous leukemia. It has several characteristic features, including distinctive morphology, chromosomal translocation, t(1517), disseminated intravascular coagulation and effect on retinoic acid. Retinoic acid which is a derivative of vitamin A induces differentation of APL cells in vitro and in vivo, but its cessation induces relapse of APL. Arsenic trioxide(AszOz) can induce clinical remission in patients with APL, including those who have relapsed after retinonic acid treatment. We report a case of a 9-year-old male with APL who had relapsed after cessation of retinoic acid treatment. The patient successfully achieved remission following treatment with AsO. Arsenic trioxide treatment would be an effective and relatively safe drug in childhood APL patients refractory to retinoic acid.