Arsenic absorption and retention in acute promyelocytic leukemia patients treated with tetra-arsenic tetra-sulfide / 中国实验血液学杂志

ABSTRACT

The objective of this study was to investigate arsenic absorption and retention in acute promyelocytic leukemia (APL) patients treated with tetra-arsenic tetra-sulfide (As(4)S(4)). Arsenic concentrations in samples from APL patients were quantitatively determinated by Hydride Generation Atomic Absorption Spectrometry. The results showed that blood arsenic level was 51.7 +/- 18.7 microg/L (n = 41), urine arsenic level was 2359.1 +/- 1910.6 microg/L (n = 36), and the average daily urinary arsenic excretion was 5.1 +/- 4.06 mg/day (n = 32) on the 7th-9th day after As(4)S(4) administration; blood arsenic level was 61.7 +/- 22.7 microg/L (n = 30), urine arsenic level was 2834.0 +/- 1958.3 microg/L (n = 27), the average daily urinary arsenic excretion was 6.3 +/- 4.98 mg/day (n = 24) on the 10th-12th day after As(4)S(4) administration; blood arsenic level was 62.8 +/- 25.1 microg/L (n = 34), urine arsenic level was 2859.3 +/- 2298.2 microg/L (n = 32) and the average daily urinary arsenic excretion was 6.82 +/- 5.58 mg/day (n = 32) on the 13th-15th day after As(4)S(4) administration. Blood arsenic level was 20.7 +/- 10.9 microg/L (n = 31), urine arsenic level was 525.5 +/- 337.1 microg/L (n = 28), and the average daily urinary arsenic excretion was 1.76 +/- 1.3 mg/day (n = 17) on the 7th-9th day after stop of treatment; blood arsenic level was 16.1 +/- 10.1 microg/L (n = 34), urine arsenic level was 207.1 +/- 164.5 microg/L (n = 28) and the average daily urinary arsenic excretion was 0.42 +/- 0.27 mg/day (n = 22) on the 13th-15th day after stop of treatment. Blood arsenic concentration, urine arsenic concentration and daily urinary arsenic excretion reach a steady state after treatment with As(4)S(4) for 10 days. The average urinary arsenic excretion was 6.82 +/- 5.58 mg/day (n = 32), arsenic absorption level was 9.74 +/- 7.97 mg/day and arsenic absorption efficiency was 0.25 +/- 0.20% during treatment. In conclusion, the majority of absorbed arsenic was excreted from urine and other ways, only a small part of absorbed arsenic was retained in body at the 14th day after therapy was discontinued, blood arsenic concentration, urine arsenic concentration, daily urinary arsenic excretion and hair arsenic concentration could be considered as useful biomarkers for monitoring arsenic absorption and retention in APL patients treated with As(4)S(4).