Is Trioxide Arsenic useful for the treatment of acute myeloid non-promylocytic leukaemia?

Abstract

Introduction: Acute leukaemia has a severe clinical process and can be rapidly fatal if it is not treated. Despite the modern treatment, many patients die due to the nature of the disease or the treatment side effects. Among the proposed forms of treatment, there is no standard and uniform treatment for those who are not completely remitted or those who had a reactivation of the disease. Therefore, it is emphasis to a newer treatment as a medical emergency. With due attention to the toxicity of the cytotoxic drugs, a series of non-toxic treatment options have been proposed. One of the newer drugs which are used for the treatment of acute leukaemia is Trioxide Arsenic. Because of the appropriate response of acute promylocytic leukaemia (APL) to Trioxide Arsenic and because of its relatively lower side effects, we decided to use it for the treatment of acute myeloid leukaemia (non-promylocytic) (AML) which was resistant to drug therapy. Aim of the Study: We aimed to assess the complete remission with Trioxide Arsenic in patients with acute myeloid leukaemia (non-promylocytic) who were resistant to therapy and its correlation with the age and duration of the disease from the diagnosis to the treatment. Material and Method: Patients with acute myeloid leukaemia, who were resistant to the treatment, were enrolled in the study. A complete history was obtained and a complete physical examination was done before the treatment. Peripheral blood smear and bone marrow examinations were done during the therapy, every two weeks. The treatment with Trioxide Arsenic was started. The complete remission was confirmed according to the standard definition of remission for acute myelogenic leukaemia. Results: In our study, out of 7 patients, one had complete remission, one had partial remission and 4 patients had no remissions. One patient abandoned the study. There was no significant correlation between the times of the treatment, from the beginning of the disease until the beginning of the treatment. Also, there was no significant correlation between the age of the patients and their response to Trioxide Arsenic. The median survival for the patients was 3.66 months and all the patients who responded and did not respond to the treatment, died. Conclusion: According to the median survival of the patients, it seems that Trioxide Arsenic alone is not a good drug for the treatment of acute myeloid non-promylocytic leukaemia. However, with regards to one complete remission and one partial remission and the lesser side effects of Trioxide Arsenic, we recommend the use of this drug in clinical trials and in the lab cultures of the leukaemic cells.